{ "canonical_url": "https://planbeforeyoudie.app/guides/advance-directive-forms-by-state", "columns": [ "state", "code", "advance", "execution", "polst", "financial", "advance_url", "execution_url", "polst_url", "financial_url", "conditions", "office_url", "complete_row_json", "fact_slugs", "source_urls", "publishers", "source_provenance_json", "checked_on", "next_check_on" ], "content_sha256": "2490a776221448264ad9137eb79faf75bed6daf3ba46d457b2d470b4f448bb13", "dataset_version": "1", "license": "https://creativecommons.org/licenses/by/4.0/", "name": "Official advance directive and power of attorney sources by state", "note": "General information, not legal advice. Each row links to the official source we checked.", "publisher": "Plan Before You Die", "rows": [ { "advance": "Advance Directive for Health Care", "advance_url": "https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf", "checked_on": "2026-10-22", "code": "AL", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-al-advance\"], \"text\": \"Advance Directive for Health Care\", \"url\": \"https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf\"}, \"execution\": {\"facts\": [\"s10-al-execution\"], \"quote\": true, \"text\": \"Witnesses (need two witnesses to sign) I am witnessing this form because I believe this person to be of sound mind. I did not sign the person’s signature, and I am not the health care proxy. I am not related to the person by blood, adoption, or marriage and not entitled to any part of his or her estate. I am at least 19 years of age and am not directly responsible for paying for his or her medical care.\", \"url\": \"https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf\"}, \"polst\": {\"facts\": [\"s10-al-dnar\"], \"text\": \"Portable Physician Do Not Attempt Resuscitation Order. This is a narrower DNAR order.\", \"url\": \"https://www.alabamapublichealth.gov/providerstandards/advance-directives.html\"}}, \"facts\": [\"s10-al-advance\", \"s10-al-dnar\", \"s10-al-execution\"], \"id\": \"al\", \"notes\": [], \"office_url\": \"https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf\", \"state\": \"Alabama\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Witnesses (need two witnesses to sign) I am witnessing this form because I believe this person to be of sound mind. I did not sign the person’s signature, and I am not the health care proxy. I am not related to the person by blood, adoption, or marriage and not entitled to any part of his or her estate. I am at least 19 years of age and am not directly responsible for paying for his or her medical care.", "execution_url": "https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf", "fact_slugs": "s10-al-advance; s10-al-dnar; s10-al-execution", "financial": "Not published", "financial_url": "https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf", "next_check_on": "2027-01-22", "office_url": "https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf", "polst": "Portable Physician Do Not Attempt Resuscitation Order. This is a narrower DNAR order.", "polst_url": "https://www.alabamapublichealth.gov/providerstandards/advance-directives.html", "publishers": "Alabama Department of Public Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Alabama Department of Public Health\", \"quote\": \"This form may be used in the State of Alabama to make your wishes known about what medical treatment or other care you would or would not want if you become too sick to speak for yourself.\", \"slug\": \"s10-al-advance\", \"source_url\": \"https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Alabama Department of Public Health\", \"quote\": \"In 2016, the Alabama Legislature passed Act #2016-96, amending Alabama's Natural Death Act to create a valid portable Do Not Attempt Resuscitation (DNAR) order that transfers from one health care facility to the next facility if it is issued using a properly completed and executed form found in the Alabama Department of Public Health's Administrative Rule 420-5-19, Appendix II.\", \"slug\": \"s10-al-dnar\", \"source_url\": \"https://www.alabamapublichealth.gov/providerstandards/advance-directives.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Alabama Department of Public Health\", \"quote\": \"Witnesses (need two witnesses to sign) I am witnessing this form because I believe this person to be of sound mind. I did not sign the person’s signature, and I am not the health care proxy. I am not related to the person by blood, adoption, or marriage and not entitled to any part of his or her estate. I am at least 19 years of age and am not directly responsible for paying for his or her medical care.\", \"slug\": \"s10-al-execution\", \"source_url\": \"https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf\"}]", "source_urls": "https://www.alabamapublichealth.gov/cancer/assets/advdirective.pdf; https://www.alabamapublichealth.gov/providerstandards/advance-directives.html", "state": "Alabama" }, { "advance": "Court referral to Advance Health Care Directive forms and instructions", "advance_url": "https://courts.alaska.gov/shc/probate/before-death.htm", "checked_on": "2026-10-22", "code": "AK", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ak-advance-referral\"], \"text\": \"Court referral to Advance Health Care Directive forms and instructions\", \"url\": \"https://courts.alaska.gov/shc/probate/before-death.htm\"}, \"execution\": {\"facts\": [], \"quote\": false, \"text\": \"Not published\", \"url\": \"https://courts.alaska.gov/shc/probate/before-death.htm\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://courts.alaska.gov/shc/probate/before-death.htm\"}, \"polst\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://courts.alaska.gov/shc/probate/before-death.htm\"}}, \"facts\": [\"s10-ak-advance-referral\"], \"id\": \"ak\", \"notes\": [], \"office_url\": \"https://courts.alaska.gov/shc/probate/before-death.htm\", \"state\": \"Alaska\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Not published", "execution_url": "https://courts.alaska.gov/shc/probate/before-death.htm", "fact_slugs": "s10-ak-advance-referral", "financial": "Not published", "financial_url": "https://courts.alaska.gov/shc/probate/before-death.htm", "next_check_on": "2027-01-22", "office_url": "https://courts.alaska.gov/shc/probate/before-death.htm", "polst": "Not published", "polst_url": "https://courts.alaska.gov/shc/probate/before-death.htm", "publishers": "Alaska Court System", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Alaska Court System\", \"quote\": \"If you want to control these decisions you can create a Health Care Directive and Living Will. For information about Advance Health Care directives and Living Wills, please see Advance Health Care Directive forms and instructions (Word Document).\", \"slug\": \"s10-ak-advance-referral\", \"source_url\": \"https://courts.alaska.gov/shc/probate/before-death.htm\"}]", "source_urls": "https://courts.alaska.gov/shc/probate/before-death.htm", "state": "Alaska" }, { "advance": "Health Care Power of Attorney", "advance_url": "https://www.azag.gov/sites/default/files/2026-08/LCP%20-%20Healthcare%20POA_8.4.26.pdf", "checked_on": "2026-10-22", "code": "AZ", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-az-advance\"], \"text\": \"Health Care Power of Attorney\", \"url\": \"https://www.azag.gov/sites/default/files/2026-08/LCP%20-%20Healthcare%20POA_8.4.26.pdf\"}, \"execution\": {\"facts\": [\"s10-az-execution\"], \"quote\": true, \"text\": \"At least one adult witness, not to include the proxy if there is one, OR a notary public must witness you signing this document. DO NOT have the documents signed by both a witness and a notary, just pick one. If you do not know a notary or cannot pay for one, a witness is legally accepted. Witnesses or notary public CANNOT be anyone who is: (a) under the age of 18 (b) related to you by blood, adoption, or marriage (c) entitled to any part of your estate (d) appointed as your agent (e) involved in providing your health care at the time this form is signed\", \"url\": \"https://www.azag.gov/sites/default/files/2026-08/LCP%20-%20Healthcare%20POA_8.4.26.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.azag.gov/issues/elder-affairs/life-care-planning\"}, \"polst\": {\"facts\": [\"s10-az-polst\"], \"text\": \"POLST form referral\", \"url\": \"https://www.azag.gov/issues/elder-affairs/life-care-planning\"}}, \"facts\": [\"s10-az-advance\", \"s10-az-execution\", \"s10-az-polst\"], \"id\": \"az\", \"notes\": [], \"office_url\": \"https://www.azag.gov/issues/elder-affairs/life-care-planning\", \"state\": \"Arizona\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "At least one adult witness, not to include the proxy if there is one, OR a notary public must witness you signing this document. DO NOT have the documents signed by both a witness and a notary, just pick one. If you do not know a notary or cannot pay for one, a witness is legally accepted. Witnesses or notary public CANNOT be anyone who is: (a) under the age of 18 (b) related to you by blood, adoption, or marriage (c) entitled to any part of your estate (d) appointed as your agent (e) involved in providing your health care at the time this form is signed", "execution_url": "https://www.azag.gov/sites/default/files/2026-08/LCP%20-%20Healthcare%20POA_8.4.26.pdf", "fact_slugs": "s10-az-advance; s10-az-execution; s10-az-polst", "financial": "Not published", "financial_url": "https://www.azag.gov/issues/elder-affairs/life-care-planning", "next_check_on": "2027-01-22", "office_url": "https://www.azag.gov/issues/elder-affairs/life-care-planning", "polst": "POLST form referral", "polst_url": "https://www.azag.gov/issues/elder-affairs/life-care-planning", "publishers": "Arizona Attorney General", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Arizona Attorney General\", \"quote\": \"GENERAL INSTRUCTIONS: Use this form if you want to select a person, called an “agent”, to make future health care decisions for you so that if you become too ill or cannot make those decisions for yourself the person you choose and trust can make medical decisions for you. Be sure you understand the importance of this document. It is a good idea to talk to your doctor and loved ones if you have questions about the type of health care you do or do not want.\", \"slug\": \"s10-az-advance\", \"source_url\": \"https://www.azag.gov/sites/default/files/2026-08/LCP%20-%20Healthcare%20POA_8.4.26.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Arizona Attorney General\", \"quote\": \"At least one adult witness, not to include the proxy if there is one, OR a notary public must witness you signing this document. DO NOT have the documents signed by both a witness and a notary, just pick one. If you do not know a notary or cannot pay for one, a witness is legally accepted. Witnesses or notary public CANNOT be anyone who is: (a) under the age of 18 (b) related to you by blood, adoption, or marriage (c) entitled to any part of your estate (d) appointed as your agent (e) involved in providing your health care at the time this form is signed\", \"slug\": \"s10-az-execution\", \"source_url\": \"https://www.azag.gov/sites/default/files/2026-08/LCP%20-%20Healthcare%20POA_8.4.26.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Arizona Attorney General\", \"quote\": \"POLST Form - This form is for when you become seriously ill or frail and toward the end of life.\", \"slug\": \"s10-az-polst\", \"source_url\": \"https://www.azag.gov/issues/elder-affairs/life-care-planning\"}]", "source_urls": "https://www.azag.gov/issues/elder-affairs/life-care-planning; https://www.azag.gov/sites/default/files/2026-08/LCP%20-%20Healthcare%20POA_8.4.26.pdf", "state": "Arizona" }, { "advance": "Advance Care Plan", "advance_url": "https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf", "checked_on": "2026-10-22", "code": "AR", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ar-advance\"], \"text\": \"Advance Care Plan\", \"url\": \"https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf\"}, \"execution\": {\"facts\": [\"s10-ar-execution\"], \"quote\": true, \"text\": \"Your signature should either be witnessed by two competent adults or notarized. If witnessed, neither witness should be the person you appointed as your agent, and at least one of the witnesses should be someone who is not related to you or entitled to any part of your estate.\", \"url\": \"https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf\"}, \"polst\": {\"facts\": [\"s10-ar-polst\"], \"text\": \"Arkansas Physician Orders for Life-Sustaining Treatment\", \"url\": \"https://healthy.arkansas.gov/programs-services/certificates-records/polst/polst-forms-directions/\"}}, \"facts\": [\"s10-ar-advance\", \"s10-ar-execution\", \"s10-ar-polst\", \"s10-ar-polst-distinct\"], \"id\": \"ar\", \"notes\": [{\"facts\": [\"s10-ar-polst-distinct\"], \"text\": \"POLST does not replace an advance directive.\"}], \"office_url\": \"https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf\", \"state\": \"Arkansas\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. POLST does not replace an advance directive.", "execution": "Your signature should either be witnessed by two competent adults or notarized. If witnessed, neither witness should be the person you appointed as your agent, and at least one of the witnesses should be someone who is not related to you or entitled to any part of your estate.", "execution_url": "https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf", "fact_slugs": "s10-ar-advance; s10-ar-execution; s10-ar-polst; s10-ar-polst-distinct", "financial": "Not published", "financial_url": "https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf", "next_check_on": "2027-01-22", "office_url": "https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf", "polst": "Arkansas Physician Orders for Life-Sustaining Treatment", "polst_url": "https://healthy.arkansas.gov/programs-services/certificates-records/polst/polst-forms-directions/", "publishers": "Arkansas Department of Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Arkansas Department of Health\", \"quote\": \"Competent adults and emancipated minors may give advance instructions using this form or any form of their own choosing. To be legally binding, the Advance Care Plan must be signed and either witnessed or notarized.\", \"slug\": \"s10-ar-advance\", \"source_url\": \"https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Arkansas Department of Health\", \"quote\": \"Your signature should either be witnessed by two competent adults or notarized. If witnessed, neither witness should be the person you appointed as your agent, and at least one of the witnesses should be someone who is not related to you or entitled to any part of your estate.\", \"slug\": \"s10-ar-execution\", \"source_url\": \"https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Arkansas Department of Health\", \"quote\": \"AR POLST (Physician Orders for Life-Sustaining Treatment) is an easily identifiable pink document that translates a patient’s goals of care and treatment preferences for end-of-life care into a physician order that transfers across AR health care settings.\", \"slug\": \"s10-ar-polst\", \"source_url\": \"https://healthy.arkansas.gov/programs-services/certificates-records/polst/polst-forms-directions/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Arkansas Department of Health\", \"quote\": \"AR POLST does not replace an advance directive for health care but can be used to operationalize the directives of the living will.\", \"slug\": \"s10-ar-polst-distinct\", \"source_url\": \"https://healthy.arkansas.gov/programs-services/certificates-records/polst/polst-forms-directions/\"}]", "source_urls": "https://healthy.arkansas.gov/programs-services/certificates-records/polst/polst-forms-directions/; https://healthy.arkansas.gov/wp-content/uploads/AdvanceCarePlanForm.pdf", "state": "Arkansas" }, { "advance": "Statutory Advance Health Care Directive", "advance_url": "https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf", "checked_on": "2026-10-22", "code": "CA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ca-advance\"], \"text\": \"Statutory Advance Health Care Directive\", \"url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\"}, \"execution\": {\"facts\": [\"s10-ca-execution\"], \"quote\": true, \"text\": \"After completing this form, sign and date the form at the end. The form must be signed by two qualified witnesses or acknowledged before a notary public.\", \"url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\"}, \"financial\": {\"facts\": [\"s10-ca-financial-form\"], \"text\": \"California Statutory Power of Attorney form\", \"url\": \"https://selfhelp.courts.ca.gov/wills-estates-probate/legal-documents\"}, \"polst\": {\"facts\": [\"s10-ca-polst\"], \"text\": \"Physician Orders for Life-Sustaining Treatment. Voluntary medical-order referral.\", \"url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-09-27.aspx\"}}, \"facts\": [\"s10-ca-advance\", \"s10-ca-execution\", \"s10-ca-financial-form\", \"s10-ca-independent-witness\", \"s10-ca-nursing-facility-witness\", \"s10-ca-polst\", \"s10-ca-witness-qualifications\"], \"id\": \"ca\", \"notes\": [{\"facts\": [\"s10-ca-witness-qualifications\", \"s10-ca-independent-witness\"], \"text\": \"The form lists excluded witnesses. At least one witness must satisfy its additional family and estate-interest declaration.\"}, {\"facts\": [\"s10-ca-nursing-facility-witness\"], \"text\": \"Skilled nursing facility patients have an additional patient advocate or ombudsman statement.\"}], \"office_url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\", \"state\": \"California\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The form lists excluded witnesses. At least one witness must satisfy its additional family and estate-interest declaration. Skilled nursing facility patients have an additional patient advocate or ombudsman statement.", "execution": "After completing this form, sign and date the form at the end. The form must be signed by two qualified witnesses or acknowledged before a notary public.", "execution_url": "https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf", "fact_slugs": "s10-ca-advance; s10-ca-execution; s10-ca-financial-form; s10-ca-independent-witness; s10-ca-nursing-facility-witness; s10-ca-polst; s10-ca-witness-qualifications", "financial": "California Statutory Power of Attorney form", "financial_url": "https://selfhelp.courts.ca.gov/wills-estates-probate/legal-documents", "next_check_on": "2027-01-22", "office_url": "https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf", "polst": "Physician Orders for Life-Sustaining Treatment. Voluntary medical-order referral.", "polst_url": "https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-09-27.aspx", "publishers": "California Courts; California Department of Justice; California Department of Public Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"California Department of Justice\", \"quote\": \"4701. The statutory advance health care directive form is as follows: ADVANCE HEALTH CARE DIRECTIVE (California Probate Code Section 4701)\", \"slug\": \"s10-ca-advance\", \"source_url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"California Department of Justice\", \"quote\": \"After completing this form, sign and date the form at the end. The form must be signed by two qualified witnesses or acknowledged before a notary public.\", \"slug\": \"s10-ca-execution\", \"source_url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"California Courts\", \"quote\": \"The California Statutory Power of Attorney form lets you appoint someone you trust to handle some or all your financial, real estate, tax, or other matters. You decide which ones.\", \"slug\": \"s10-ca-financial-form\", \"source_url\": \"https://selfhelp.courts.ca.gov/wills-estates-probate/legal-documents\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"California Department of Justice\", \"quote\": \"ADDITIONAL STATEMENT OF WITNESSES: At least one of the above witnesses must also sign the following declaration: I further declare under penalty of perjury under the laws of California that I am not related to the individual executing this advance health care directive by blood, marriage, or adoption, and to the best of my knowledge, I am not entitled to any part of the individual's estate upon his or her death under a will now existing or by operation of law.\", \"slug\": \"s10-ca-independent-witness\", \"source_url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"California Department of Justice\", \"quote\": \"The following statement is required only if you are a patient in a skilled nursing facility--a health care facility that provides the following basic services: skilled nursing care and supportive care to patients whose primary need is for availability of skilled nursing care on an extended basis. The patient advocate or ombudsman must sign the following statement:\", \"slug\": \"s10-ca-nursing-facility-witness\", \"source_url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"California Department of Public Health\", \"quote\": \"The POLST form and medical intervention and procedures offered are a voluntary option for people to use to communicate their end-of-life decisions.\", \"slug\": \"s10-ca-polst\", \"source_url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-09-27.aspx\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"California Department of Justice\", \"quote\": \"STATEMENT OF WITNESSES: I declare under penalty of perjury under the laws of California (1) that the individual who signed or acknowledged this advance health care directive is personally known to me, or that the individual's identity was proven to me by convincing evidence (2) that the individual signed or acknowledged this advance directive in my presence, (3) that the individual appears to be of sound mind and under no duress, fraud, or undue influence, (4) that I am not a person appointed as agent by this advance directive, and (5) that I am not the individual's health care provider, an employee of the individual's health care provider, the operator of a community care facility, an employee of an operator of a community care facility, the operator of a residential care facility for the elderly, nor an employee of an operator of a residential care facility for the elderly.\", \"slug\": \"s10-ca-witness-qualifications\", \"source_url\": \"https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf\"}]", "source_urls": "https://oag.ca.gov/system/files/media/ProbateCodeAdvanceHealthCareDirectiveForm-fillable.pdf; https://selfhelp.courts.ca.gov/wills-estates-probate/legal-documents; https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-09-27.aspx", "state": "California" }, { "advance": "Not published", "advance_url": "https://olls.info/crs/crs2026-title-15.pdf", "checked_on": "2026-10-22", "code": "CO", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}, \"execution\": {\"facts\": [\"s10-co-declaration-execution\"], \"quote\": true, \"text\": \"(a) Signed by the declarant in the presence of two witnesses; or (b) Signed by the declarant and acknowledged before a notary public or other individual authorized by law to take acknowledgments, unless a court determines that this subsection (1)(b) should not apply to the declaration in the interest of justice. (2) For the purposes of this section, a person specified in section 15-18-105 shall not be a witness, notary public, or other individual authorized by law to take acknowledgments.\", \"url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}, \"financial\": {\"facts\": [\"s10-co-financial-form\"], \"text\": \"Statutory form power of attorney\", \"url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}, \"polst\": {\"facts\": [\"s10-co-most\"], \"text\": \"Medical Orders for Scope of Treatment. Statutory form requirements. \", \"url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}}, \"facts\": [\"s10-co-declaration-disqualifications\", \"s10-co-declaration-execution\", \"s10-co-financial-form\", \"s10-co-most\"], \"id\": \"co\", \"notes\": [{\"facts\": [\"s10-co-declaration-execution\", \"s10-co-declaration-disqualifications\"], \"text\": \"The quoted execution rule applies to a declaration as to medical treatment. The statute lists excluded witnesses and a separate route when the declarant cannot physically sign.\"}], \"office_url\": \"https://olls.info/crs/crs2026-title-15.pdf\", \"state\": \"Colorado\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The quoted execution rule applies to a declaration as to medical treatment. The statute lists excluded witnesses and a separate route when the declarant cannot physically sign.", "execution": "(a) Signed by the declarant in the presence of two witnesses; or (b) Signed by the declarant and acknowledged before a notary public or other individual authorized by law to take acknowledgments, unless a court determines that this subsection (1)(b) should not apply to the declaration in the interest of justice. (2) For the purposes of this section, a person specified in section 15-18-105 shall not be a witness, notary public, or other individual authorized by law to take acknowledgments.", "execution_url": "https://olls.info/crs/crs2026-title-15.pdf", "fact_slugs": "s10-co-declaration-disqualifications; s10-co-declaration-execution; s10-co-financial-form; s10-co-most", "financial": "Statutory form power of attorney", "financial_url": "https://olls.info/crs/crs2026-title-15.pdf", "next_check_on": "2027-01-22", "office_url": "https://olls.info/crs/crs2026-title-15.pdf", "polst": "Medical Orders for Scope of Treatment. Statutory form requirements. ", "polst_url": "https://olls.info/crs/crs2026-title-15.pdf", "publishers": "Colorado General Assembly, Office of Legislative Legal Services", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Colorado General Assembly, Office of Legislative Legal Services\", \"quote\": \"In the event that the declarant is physically unable to sign the declaration, it may be signed by some other person in the declarant's presence and at the declarant's direction. The other person shall not be: (a) The attending physician or any other physician; (b) An employee of the attending physician or health-care facility in which the declarant is a patient; (c) A person who has a claim against any portion of the estate of the declarant at his or her death at the time the declaration is signed; or (d) A person who knows or believes that he or she is entitled to any portion of the estate of the declarant upon the declarant's death either as a beneficiary of a will in existence at the time the declaration is signed or as an heir at law.\", \"slug\": \"s10-co-declaration-disqualifications\", \"source_url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Colorado General Assembly, Office of Legislative Legal Services\", \"quote\": \"(a) Signed by the declarant in the presence of two witnesses; or (b) Signed by the declarant and acknowledged before a notary public or other individual authorized by law to take acknowledgments, unless a court determines that this subsection (1)(b) should not apply to the declaration in the interest of justice. (2) For the purposes of this section, a person specified in section 15-18-105 shall not be a witness, notary public, or other individual authorized by law to take acknowledgments.\", \"slug\": \"s10-co-declaration-execution\", \"source_url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Colorado General Assembly, Office of Legislative Legal Services\", \"quote\": \"15-14-741. Statutory form - power of attorney. A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by this part 7.\", \"slug\": \"s10-co-financial-form\", \"source_url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Colorado General Assembly, Office of Legislative Legal Services\", \"quote\": \"(1) A medical orders for scope of treatment form must include the following information concerning the adult whose medical treatment is the subject of the medical orders for scope of treatment form:\", \"slug\": \"s10-co-most\", \"source_url\": \"https://olls.info/crs/crs2026-title-15.pdf\"}]", "source_urls": "https://olls.info/crs/crs2026-title-15.pdf", "state": "Colorado" }, { "advance": "Combined advance directives form. Its sections are optional.", "advance_url": "https://portal.ct.gov/en/ag/health-issues/connecticuts-living-will-laws", "checked_on": "2026-10-22", "code": "CT", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ct-advance\"], \"text\": \"Combined advance directives form. Its sections are optional.\", \"url\": \"https://portal.ct.gov/en/ag/health-issues/connecticuts-living-will-laws\"}, \"execution\": {\"facts\": [\"s10-ct-execution\"], \"quote\": true, \"text\": \"(a) Any person eighteen years of age or older may appoint a health care representative by executing a document in accordance with section 19a-575a or section 19a-577 , signed and dated by such person in the presence of two adult witnesses who shall also sign the document. The person appointed as representative shall not act as witness to the execution of such document or sign such document.\", \"url\": \"https://www.cga.ct.gov/current/pub/chap_368w.htm\"}, \"financial\": {\"facts\": [\"s10-ct-financial-form\"], \"text\": \"Statutory power of attorney short and long forms\", \"url\": \"https://www.cga.ct.gov/current/pub/chap_015c.htm\"}, \"polst\": {\"facts\": [\"s10-ct-molst\"], \"text\": \"Medical Orders for Life-Sustaining Treatment\", \"url\": \"https://portal.ct.gov/dph/about/molst\"}}, \"facts\": [\"s10-ct-advance\", \"s10-ct-execution\", \"s10-ct-facility-witnesses\", \"s10-ct-financial-form\", \"s10-ct-molst\"], \"id\": \"ct\", \"notes\": [{\"facts\": [\"s10-ct-execution\", \"s10-ct-facility-witnesses\"], \"text\": \"The quoted rule concerns appointment of a health care representative. Specified mental-health and developmental-services facilities have additional witness qualifications.\"}], \"office_url\": \"https://portal.ct.gov/en/ag/health-issues/connecticuts-living-will-laws\", \"state\": \"Connecticut\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The quoted rule concerns appointment of a health care representative. Specified mental-health and developmental-services facilities have additional witness qualifications.", "execution": "(a) Any person eighteen years of age or older may appoint a health care representative by executing a document in accordance with section 19a-575a or section 19a-577 , signed and dated by such person in the presence of two adult witnesses who shall also sign the document. The person appointed as representative shall not act as witness to the execution of such document or sign such document.", "execution_url": "https://www.cga.ct.gov/current/pub/chap_368w.htm", "fact_slugs": "s10-ct-advance; s10-ct-execution; s10-ct-facility-witnesses; s10-ct-financial-form; s10-ct-molst", "financial": "Statutory power of attorney short and long forms", "financial_url": "https://www.cga.ct.gov/current/pub/chap_015c.htm", "next_check_on": "2027-01-22", "office_url": "https://portal.ct.gov/en/ag/health-issues/connecticuts-living-will-laws", "polst": "Medical Orders for Life-Sustaining Treatment", "polst_url": "https://portal.ct.gov/dph/about/molst", "publishers": "Connecticut Department of Public Health; Connecticut General Assembly; Connecticut Office of the Attorney General", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Connecticut Office of the Attorney General\", \"quote\": \"Living Will - Advance Directives Combined Form (PDF-122KB) This document contains all of the advance directives-- appointment of health care representative, living will, appointment of conservator and organ donation in one form. You do not have to create all of these directives. The form allows you to choose to not make one of the directives by signing your initials at the top of that section.\", \"slug\": \"s10-ct-advance\", \"source_url\": \"https://portal.ct.gov/en/ag/health-issues/connecticuts-living-will-laws\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Connecticut General Assembly\", \"quote\": \"(a) Any person eighteen years of age or older may appoint a health care representative by executing a document in accordance with section 19a-575a or section 19a-577 , signed and dated by such person in the presence of two adult witnesses who shall also sign the document. The person appointed as representative shall not act as witness to the execution of such document or sign such document.\", \"slug\": \"s10-ct-execution\", \"source_url\": \"https://www.cga.ct.gov/current/pub/chap_368w.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Connecticut General Assembly\", \"quote\": \"(b) For persons who reside in facilities operated or licensed by the Department of Mental Health and Addiction Services, at least one witness shall be an individual who is not affiliated with the facility and at least one witness shall be a physician, advanced practice registered nurse or licensed clinical psychologist with specialized training in treating mental illness. (c) For persons who reside in facilities operated or licensed by the Department of Developmental Services, at least one witness shall be an individual who is not affiliated with the facility and at least one witness shall be a physician, advanced practice registered nurse or licensed clinical psychologist with specialized training in developmental disabilities.\", \"slug\": \"s10-ct-facility-witnesses\", \"source_url\": \"https://www.cga.ct.gov/current/pub/chap_368w.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Connecticut General Assembly\", \"quote\": \"(a)(1) A document substantially in the form of either the short form, as set forth in subdivision (2) of this subsection, or the long form, as set forth in subdivision (3) of this subsection, may be used to create a statutory power of attorney that has the meaning and effect prescribed in sections 1-350 to 1-353b , inclusive. No provision of sections 1-350 to 1-353b , inclusive, shall be construed to bar the use of any other or different form of power of attorney desired by the parties concerned.\", \"slug\": \"s10-ct-financial-form\", \"source_url\": \"https://www.cga.ct.gov/current/pub/chap_015c.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Connecticut Department of Public Health\", \"quote\": \"Medical Orders for Life-Sustaining Treatment (MOLST) What is MOLST? MOLST is a discussion and set of medical orders that help health care providers communicate about a patient's care regarding life-sustaining treatments.\", \"slug\": \"s10-ct-molst\", \"source_url\": \"https://portal.ct.gov/dph/about/molst\"}]", "source_urls": "https://portal.ct.gov/dph/about/molst; https://portal.ct.gov/en/ag/health-issues/connecticuts-living-will-laws; https://www.cga.ct.gov/current/pub/chap_015c.htm; https://www.cga.ct.gov/current/pub/chap_368w.htm", "state": "Connecticut" }, { "advance": "Optional Advance Health-Care Directive", "advance_url": "https://delcode.delaware.gov/title16/c025/index.html", "checked_on": "2026-10-22", "code": "DE", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-de-advance\"], \"text\": \"Optional Advance Health-Care Directive\", \"url\": \"https://delcode.delaware.gov/title16/c025/index.html\"}, \"execution\": {\"facts\": [\"s10-de-execution\"], \"quote\": true, \"text\": \"(d) A power of attorney for health care must be in a record, signed by the individual creating the power, and signed by an adult witness who satisfies all of the following: (1) Reasonably believes the act of the individual to create the power of attorney is voluntary and knowing. (2) Is not the agent appointed by the individual. (3) Is not the agent’s spouse, domestic partner, or cohabitant. (4) If the individual resides or is receiving care in a nursing home or long-term care facility, is not the owner, operator, employee, or contractor of the nursing home or long-term care facility. (5) Is present when the individual signs the power of attorney or when the individual represents that the power of attorney reflects the individual’s wishes. (e) A witness under subsection (d) of this section is considered present if the witness and the individual are any of the following: (1) Physically present in the same location. (2) Using electronic means that allow for real time audio and visual transmission and communication in real time to the same extent as if the witness and the individual were physically present in the same location. (3) Able to speak to and hear each other in real time through audio connection if the identity of the individual is personally known to the witness or the witness is able to authenticate the identity of the individual by receiving accurate answers from the individual that enable the authentication.\", \"url\": \"https://delcode.delaware.gov/title16/c025/index.html\"}, \"financial\": {\"facts\": [\"s10-de-financial-form\"], \"text\": \"Statutory durable personal power of attorney form\", \"url\": \"https://delcode.delaware.gov/title12/c049a/sc03/index.html\"}, \"polst\": {\"facts\": [\"s10-de-dmost\"], \"text\": \"Delaware Medical Orders for Scope of Treatment\", \"url\": \"https://dhss.delaware.gov/dhcc/dmost/\"}}, \"facts\": [\"s10-de-advance\", \"s10-de-dmost\", \"s10-de-execution\", \"s10-de-financial-form\", \"s10-de-mental-health-exception\"], \"id\": \"de\", \"notes\": [{\"facts\": [\"s10-de-mental-health-exception\"], \"text\": \"A specified mental-health direction restricting revocation has a separate-record requirement and two physically present adult witnesses.\"}], \"office_url\": \"https://delcode.delaware.gov/title16/c025/index.html\", \"state\": \"Delaware\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. A specified mental-health direction restricting revocation has a separate-record requirement and two physically present adult witnesses.", "execution": "(d) A power of attorney for health care must be in a record, signed by the individual creating the power, and signed by an adult witness who satisfies all of the following: (1) Reasonably believes the act of the individual to create the power of attorney is voluntary and knowing. (2) Is not the agent appointed by the individual. (3) Is not the agent’s spouse, domestic partner, or cohabitant. (4) If the individual resides or is receiving care in a nursing home or long-term care facility, is not the owner, operator, employee, or contractor of the nursing home or long-term care facility. (5) Is present when the individual signs the power of attorney or when the individual represents that the power of attorney reflects the individual’s wishes. (e) A witness under subsection (d) of this section is considered present if the witness and the individual are any of the following: (1) Physically present in the same location. (2) Using electronic means that allow for real time audio and visual transmission and communication in real time to the same extent as if the witness and the individual were physically present in the same location. (3) Able to speak to and hear each other in real time through audio connection if the identity of the individual is personally known to the witness or the witness is able to authenticate the identity of the individual by receiving accurate answers from the individual that enable the authentication.", "execution_url": "https://delcode.delaware.gov/title16/c025/index.html", "fact_slugs": "s10-de-advance; s10-de-dmost; s10-de-execution; s10-de-financial-form; s10-de-mental-health-exception", "financial": "Statutory durable personal power of attorney form", "financial_url": "https://delcode.delaware.gov/title12/c049a/sc03/index.html", "next_check_on": "2027-01-22", "office_url": "https://delcode.delaware.gov/title16/c025/index.html", "polst": "Delaware Medical Orders for Scope of Treatment", "polst_url": "https://dhss.delaware.gov/dhcc/dmost/", "publishers": "Delaware Department of Health and Social Services; Delaware General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Delaware General Assembly\", \"quote\": \"The following form may be used to create an advance health-care directive: ADVANCE HEALTH-CARE DIRECTIVE HOW YOU CAN USE THIS FORM You can use this form if you wish to name someone to make health-care decisions for you in case you cannot make decisions for yourself. This is called giving the person a power of attorney for health care. This person is called your Agent.\", \"slug\": \"s10-de-advance\", \"source_url\": \"https://delcode.delaware.gov/title16/c025/index.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Delaware Department of Health and Social Services\", \"quote\": \"For those with a serious illness, doctors may recommend a Delaware Medical Orders for Scope of Treatment (DMOST) form as part of their Advance Directive.\", \"slug\": \"s10-de-dmost\", \"source_url\": \"https://dhss.delaware.gov/dhcc/dmost/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Delaware General Assembly\", \"quote\": \"(d) A power of attorney for health care must be in a record, signed by the individual creating the power, and signed by an adult witness who satisfies all of the following: (1) Reasonably believes the act of the individual to create the power of attorney is voluntary and knowing. (2) Is not the agent appointed by the individual. (3) Is not the agent’s spouse, domestic partner, or cohabitant. (4) If the individual resides or is receiving care in a nursing home or long-term care facility, is not the owner, operator, employee, or contractor of the nursing home or long-term care facility. (5) Is present when the individual signs the power of attorney or when the individual represents that the power of attorney reflects the individual’s wishes. (e) A witness under subsection (d) of this section is considered present if the witness and the individual are any of the following: (1) Physically present in the same location. (2) Using electronic means that allow for real time audio and visual transmission and communication in real time to the same extent as if the witness and the individual were physically present in the same location. (3) Able to speak to and hear each other in real time through audio connection if the identity of the individual is personally known to the witness or the witness is able to authenticate the identity of the individual by receiving accurate answers from the individual that enable the authentication.\", \"slug\": \"s10-de-execution\", \"source_url\": \"https://delcode.delaware.gov/title16/c025/index.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Delaware General Assembly\", \"quote\": \"As the person signing this durable power of attorney you are the Principal. The purpose of this power of attorney is to give the person you designate (your “Agent”) broad powers to handle your property, which may include powers to sell, dispose of, or encumber any real or personal property without advance notice to you or approval by you. This power of attorney does not authorize your Agent to make health-care decisions for you.\", \"slug\": \"s10-de-financial-form\", \"source_url\": \"https://delcode.delaware.gov/title12/c049a/sc03/index.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Delaware General Assembly\", \"quote\": \"(d) An individual may direct in an advance mental health-care directive that, if the individual is experiencing a psychiatric or psychological event specified in the directive, the individual may not revoke the directive or a part of the directive. (e) If an advance mental health-care directive includes a direction under subsection (d) of this section, the advance mental health-care directive must be in a record that is separate from any other advance health-care directive created by the individual and signed by the individual creating the advance mental health-care directive and at least 2 adult witnesses who satisfy all of the following: (1) Attest that to the best of their knowledge, the individual understood the nature and consequences of the direction, including its risks and benefits. (2) Attest that to the best of their knowledge, the individual made the direction voluntarily and without coercion or undue influence. (3) Are not the agent appointed by the individual. (4) Are not the agent’s spouse, domestic partner, or cohabitant. (5) If the individual resides in a nursing home or long-term care facility, are not the owner, operator, employee, or contractor of the nursing home or long-term care facility. (6) Are physically present in the same location as the individual.\", \"slug\": \"s10-de-mental-health-exception\", \"source_url\": \"https://delcode.delaware.gov/title16/c025/index.html\"}]", "source_urls": "https://delcode.delaware.gov/title12/c049a/sc03/index.html; https://delcode.delaware.gov/title16/c025/index.html; https://dhss.delaware.gov/dhcc/dmost/", "state": "Delaware" }, { "advance": "Sample durable power of attorney for health care", "advance_url": "https://code.dccouncil.gov/us/dc/council/code/sections/21-2207", "checked_on": "2026-10-22", "code": "DC", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-dc-advance\"], \"text\": \"Sample durable power of attorney for health care\", \"url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/21-2207\"}, \"execution\": {\"facts\": [\"s10-dc-execution\"], \"quote\": true, \"text\": \"(c) A durable power of attorney for health care shall be dated and signed by the principal and 2 adult witnesses who affirm that the principal was of sound mind and free from duress at the time of signing. The 2 adult witnesses shall not include the principal, the health-care provider of the principal or an employee of the health-care provider of the principal. (d) Of the 2 adult witnesses referred to in subsection (c) of this section, at least 1 shall not be related to the principal by blood, marriage or adoption and shall not be entitled to any part of the estate of the principal by a current will or operation of law.\", \"url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/21-2205\"}, \"financial\": {\"facts\": [\"s10-dc-financial-form\"], \"text\": \"Statutory power of attorney form. Additional real-estate notice requirements may apply.\", \"url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/21-2603.01\"}, \"polst\": {\"facts\": [\"s10-dc-most\"], \"text\": \"Medical Orders for Scope of Treatment\", \"url\": \"https://dchealth.dc.gov/most\"}}, \"facts\": [\"s10-dc-advance\", \"s10-dc-execution\", \"s10-dc-financial-form\", \"s10-dc-most\"], \"id\": \"dc\", \"notes\": [], \"office_url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/21-2207\", \"state\": \"Washington, DC\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "(c) A durable power of attorney for health care shall be dated and signed by the principal and 2 adult witnesses who affirm that the principal was of sound mind and free from duress at the time of signing. The 2 adult witnesses shall not include the principal, the health-care provider of the principal or an employee of the health-care provider of the principal. (d) Of the 2 adult witnesses referred to in subsection (c) of this section, at least 1 shall not be related to the principal by blood, marriage or adoption and shall not be entitled to any part of the estate of the principal by a current will or operation of law.", "execution_url": "https://code.dccouncil.gov/us/dc/council/code/sections/21-2205", "fact_slugs": "s10-dc-advance; s10-dc-execution; s10-dc-financial-form; s10-dc-most", "financial": "Statutory power of attorney form. Additional real-estate notice requirements may apply.", "financial_url": "https://code.dccouncil.gov/us/dc/council/code/sections/21-2603.01", "next_check_on": "2027-01-22", "office_url": "https://code.dccouncil.gov/us/dc/council/code/sections/21-2207", "polst": "Medical Orders for Scope of Treatment", "polst_url": "https://dchealth.dc.gov/most", "publishers": "Council of the District of Columbia; District of Columbia Department of Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Council of the District of Columbia\", \"quote\": \"Any written form meeting the requirements of § 21-2205 may be used to create a durable power of attorney for health care. The following is offered as a sample form only and its inclusion in this section shall not be construed to preclude the use of alternative language:\", \"slug\": \"s10-dc-advance\", \"source_url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/21-2207\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Council of the District of Columbia\", \"quote\": \"(c) A durable power of attorney for health care shall be dated and signed by the principal and 2 adult witnesses who affirm that the principal was of sound mind and free from duress at the time of signing. The 2 adult witnesses shall not include the principal, the health-care provider of the principal or an employee of the health-care provider of the principal. (d) Of the 2 adult witnesses referred to in subsection (c) of this section, at least 1 shall not be related to the principal by blood, marriage or adoption and shall not be entitled to any part of the estate of the principal by a current will or operation of law.\", \"slug\": \"s10-dc-execution\", \"source_url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/21-2205\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Council of the District of Columbia\", \"quote\": \"A document substantially in the following form, and potentially subject to the additional notice requirement of § 21-2603.03 for powers governing real estate transactions, may be used to create a statutory power of attorney form that has the meaning and effect prescribed by this chapter:\", \"slug\": \"s10-dc-financial-form\", \"source_url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/21-2603.01\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"District of Columbia Department of Health\", \"quote\": \"The electronic MOST form provides a more comprehensive approach, empowering terminally-ill patients the right to make decisions on their end-of-life care options, in consultation with their DC-licensed authorized healthcare provider (Physician (MD/DO) or Advanced Practice Registered Nurse (APRN) only).\", \"slug\": \"s10-dc-most\", \"source_url\": \"https://dchealth.dc.gov/most\"}]", "source_urls": "https://code.dccouncil.gov/us/dc/council/code/sections/21-2205; https://code.dccouncil.gov/us/dc/council/code/sections/21-2207; https://code.dccouncil.gov/us/dc/council/code/sections/21-2603.01; https://dchealth.dc.gov/most", "state": "Washington, DC" }, { "advance": "Suggested designation of health care surrogate", "advance_url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html", "checked_on": "2026-10-22", "code": "FL", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-fl-advance\"], \"text\": \"Suggested designation of health care surrogate\", \"url\": \"https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html\"}, \"execution\": {\"facts\": [\"s10-fl-execution\"], \"quote\": true, \"text\": \"A written document designating a surrogate to make health care decisions for a principal or receive health information on behalf of a principal, or both, shall be signed by the principal in the presence of two subscribing adult witnesses. A principal unable to sign the instrument may, in the presence of witnesses, direct that another person sign the principal’s name as required herein. An exact copy of the instrument shall be provided to the surrogate. (2) The person designated as surrogate shall not act as witness to the execution of the document designating the health care surrogate. At least one person who acts as a witness shall be neither the principal’s spouse nor blood relative.\", \"url\": \"https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.202.html\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html\"}, \"polst\": {\"facts\": [\"s10-fl-dnro\"], \"text\": \"Do Not Resuscitate Order. This is a narrower resuscitation order.\", \"url\": \"https://www.floridahealth.gov/about-us/resources/do-not-resuscitate-order/\"}}, \"facts\": [\"s10-fl-advance\", \"s10-fl-dnro\", \"s10-fl-execution\"], \"id\": \"fl\", \"notes\": [], \"office_url\": \"https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html\", \"state\": \"Florida\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "A written document designating a surrogate to make health care decisions for a principal or receive health information on behalf of a principal, or both, shall be signed by the principal in the presence of two subscribing adult witnesses. A principal unable to sign the instrument may, in the presence of witnesses, direct that another person sign the principal’s name as required herein. An exact copy of the instrument shall be provided to the surrogate. (2) The person designated as surrogate shall not act as witness to the execution of the document designating the health care surrogate. At least one person who acts as a witness shall be neither the principal’s spouse nor blood relative.", "execution_url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.202.html", "fact_slugs": "s10-fl-advance; s10-fl-dnro; s10-fl-execution", "financial": "Not published", "financial_url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html", "next_check_on": "2027-01-22", "office_url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html", "polst": "Do Not Resuscitate Order. This is a narrower resuscitation order.", "polst_url": "https://www.floridahealth.gov/about-us/resources/do-not-resuscitate-order/", "publishers": "Florida Department of Health; Florida Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Florida Legislature\", \"quote\": \"A written designation of a health care surrogate executed pursuant to this chapter may, but need not be, in the following form:\", \"slug\": \"s10-fl-advance\", \"source_url\": \"https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Florida Department of Health\", \"quote\": \"A do not resuscitate order (DNRO) is a form or patient identification device developed by the Florida Department of Health to identify people who do not wish to be resuscitated in the event of respiratory or cardiac arrest.\", \"slug\": \"s10-fl-dnro\", \"source_url\": \"https://www.floridahealth.gov/about-us/resources/do-not-resuscitate-order/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Florida Legislature\", \"quote\": \"A written document designating a surrogate to make health care decisions for a principal or receive health information on behalf of a principal, or both, shall be signed by the principal in the presence of two subscribing adult witnesses. A principal unable to sign the instrument may, in the presence of witnesses, direct that another person sign the principal’s name as required herein. An exact copy of the instrument shall be provided to the surrogate. (2) The person designated as surrogate shall not act as witness to the execution of the document designating the health care surrogate. At least one person who acts as a witness shall be neither the principal’s spouse nor blood relative.\", \"slug\": \"s10-fl-execution\", \"source_url\": \"https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.202.html\"}]", "source_urls": "https://www.floridahealth.gov/about-us/resources/do-not-resuscitate-order/; https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.202.html; https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/Sections/0765.203.html", "state": "Florida" }, { "advance": "Attorney general referral to Georgia Advance Directive for Health Care", "advance_url": "https://consumer.georgia.gov/advance-directives", "checked_on": "2026-10-22", "code": "GA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ga-advance-referral\"], \"text\": \"Attorney general referral to Georgia Advance Directive for Health Care\", \"url\": \"https://consumer.georgia.gov/advance-directives\"}, \"execution\": {\"facts\": [], \"quote\": false, \"text\": \"Not published\", \"url\": \"https://consumer.georgia.gov/advance-directives\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://consumer.georgia.gov/advance-directives\"}, \"polst\": {\"facts\": [\"s10-ga-polst\"], \"text\": \"Physician Orders for Life-Sustaining Treatment\", \"url\": \"https://dph.georgia.gov/POLST\"}}, \"facts\": [\"s10-ga-advance-referral\", \"s10-ga-polst\"], \"id\": \"ga\", \"notes\": [], \"office_url\": \"https://consumer.georgia.gov/advance-directives\", \"state\": \"Georgia\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Not published", "execution_url": "https://consumer.georgia.gov/advance-directives", "fact_slugs": "s10-ga-advance-referral; s10-ga-polst", "financial": "Not published", "financial_url": "https://consumer.georgia.gov/advance-directives", "next_check_on": "2027-01-22", "office_url": "https://consumer.georgia.gov/advance-directives", "polst": "Physician Orders for Life-Sustaining Treatment", "polst_url": "https://dph.georgia.gov/POLST", "publishers": "Georgia Department of Public Health; Georgia Office of the Attorney General", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Georgia Office of the Attorney General\", \"quote\": \"To access the Georgia Advance Directive for Health Care form , visit the Georgia Division of Aging Services’ website at aging.georgia.gov/get-advance-directives .\", \"slug\": \"s10-ga-advance-referral\", \"source_url\": \"https://consumer.georgia.gov/advance-directives\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Georgia Department of Public Health\", \"quote\": \"Download the Georgia POLST form (PDF, 289.48 KB) . Download the Georgia POLST form (Espanol) (PDF, 171.38 KB) .\", \"slug\": \"s10-ga-polst\", \"source_url\": \"https://dph.georgia.gov/POLST\"}]", "source_urls": "https://consumer.georgia.gov/advance-directives; https://dph.georgia.gov/POLST", "state": "Georgia" }, { "advance": "Advance Health Care Directive", "advance_url": "https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf", "checked_on": "2026-10-22", "code": "HI", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-hi-advance\"], \"text\": \"Advance Health Care Directive\", \"url\": \"https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf\"}, \"execution\": {\"facts\": [\"s10-hi-execution\"], \"quote\": true, \"text\": \"Have two qualified witnesses or a notary public witness your signature.\", \"url\": \"https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf\"}, \"polst\": {\"facts\": [\"s10-hi-polst\"], \"text\": \"Provider Orders for Life-Sustaining Treatment\", \"url\": \"https://health.hawaii.gov/eoa/polst/\"}}, \"facts\": [\"s10-hi-advance\", \"s10-hi-execution\", \"s10-hi-polst\", \"s10-hi-witness-qualifications\"], \"id\": \"hi\", \"notes\": [{\"facts\": [\"s10-hi-witness-qualifications\"], \"text\": \"Witnesses cannot be the health care agent, a health care provider or a health care facility employee. One witness cannot be a relative or have inheritance rights.\"}], \"office_url\": \"https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf\", \"state\": \"Hawaii\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. Witnesses cannot be the health care agent, a health care provider or a health care facility employee. One witness cannot be a relative or have inheritance rights.", "execution": "Have two qualified witnesses or a notary public witness your signature.", "execution_url": "https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf", "fact_slugs": "s10-hi-advance; s10-hi-execution; s10-hi-polst; s10-hi-witness-qualifications", "financial": "Not published", "financial_url": "https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf", "next_check_on": "2027-01-22", "office_url": "https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf", "polst": "Provider Orders for Life-Sustaining Treatment", "polst_url": "https://health.hawaii.gov/eoa/polst/", "publishers": "Hawaii Department of Health, Executive Office on Aging", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Hawaii Department of Health, Executive Office on Aging\", \"quote\": \"Complete the enclosed optional Advance Health Care Directive or make a document of your own. You can add more pages if needed.\", \"slug\": \"s10-hi-advance\", \"source_url\": \"https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Hawaii Department of Health, Executive Office on Aging\", \"quote\": \"Have two qualified witnesses or a notary public witness your signature.\", \"slug\": \"s10-hi-execution\", \"source_url\": \"https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Hawaii Department of Health, Executive Office on Aging\", \"quote\": \"Provider Orders for Life-Sustaining Treatment (POLST) is a medical order signed by a doctor, nurse practitioner, or physician assistant that records your preferences for life-sustaining treatments.\", \"slug\": \"s10-hi-polst\", \"source_url\": \"https://health.hawaii.gov/eoa/polst/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Hawaii Department of Health, Executive Office on Aging\", \"quote\": \"Important: Witnesses cannot be your health-care agent, a health-care provider or an employee of a health-care facility. One witness cannot be a relative or have inheritance rights.\", \"slug\": \"s10-hi-witness-qualifications\", \"source_url\": \"https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf\"}]", "source_urls": "https://health.hawaii.gov/eoa/files/2013/04/AHCD.pdf; https://health.hawaii.gov/eoa/polst/", "state": "Hawaii" }, { "advance": "Idaho Advance Directive and update resources", "advance_url": "https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/", "checked_on": "2026-10-22", "code": "ID", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-id-advance\"], \"text\": \"Idaho Advance Directive and update resources\", \"url\": \"https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/\"}, \"execution\": {\"facts\": [\"s10-id-execution\"], \"quote\": true, \"text\": \"(1) Any competent person aged eighteen (18) years or older may execute an advance care planning document (ACPD). Such document must contain the mandatory elements set forth in this section. Any provisions of an ACPD that are left blank by a person executing the document shall be deemed intentional and shall not invalidate the document. The department of health and welfare may create and promulgate an optional form for the ACPD. Such form is not mandatory. To be considered a valid ACPD, a document must include: (a) The person’s name, date of birth, telephone number, and mailing address; (b) The signature of the person for whom the ACPD is created or the authorized agent of such person; and (c) The date on which the document was signed.\", \"url\": \"https://legislature.idaho.gov/statutesrules/idstat/Title39/T39CH45/SECT39-4510/\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/\"}, \"polst\": {\"facts\": [\"s10-id-post\"], \"text\": \"Physician Orders for Scope of Treatment\", \"url\": \"https://healthandwelfare.idaho.gov/services-programs/birth-marriage-death-records/idaho-healthcare-directive-registry\"}}, \"facts\": [\"s10-id-advance\", \"s10-id-execution\", \"s10-id-optional-witness-notary\", \"s10-id-post\"], \"id\": \"id\", \"notes\": [{\"facts\": [\"s10-id-optional-witness-notary\"], \"text\": \"The statute lists witness details and notarization as optional ACPD contents.\"}], \"office_url\": \"https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/\", \"state\": \"Idaho\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The statute lists witness details and notarization as optional ACPD contents.", "execution": "(1) Any competent person aged eighteen (18) years or older may execute an advance care planning document (ACPD). Such document must contain the mandatory elements set forth in this section. Any provisions of an ACPD that are left blank by a person executing the document shall be deemed intentional and shall not invalidate the document. The department of health and welfare may create and promulgate an optional form for the ACPD. Such form is not mandatory. To be considered a valid ACPD, a document must include: (a) The person’s name, date of birth, telephone number, and mailing address; (b) The signature of the person for whom the ACPD is created or the authorized agent of such person; and (c) The date on which the document was signed.", "execution_url": "https://legislature.idaho.gov/statutesrules/idstat/Title39/T39CH45/SECT39-4510/", "fact_slugs": "s10-id-advance; s10-id-execution; s10-id-optional-witness-notary; s10-id-post", "financial": "Not published", "financial_url": "https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/", "next_check_on": "2027-01-22", "office_url": "https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/", "polst": "Physician Orders for Scope of Treatment", "polst_url": "https://healthandwelfare.idaho.gov/services-programs/birth-marriage-death-records/idaho-healthcare-directive-registry", "publishers": "Idaho Department of Health and Welfare; Idaho Legislature; Idaho Office of the Attorney General", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Idaho Office of the Attorney General\", \"quote\": \"The State of Idaho offers the Idaho Advance Directive, which allows individuals to plan for future medical decisions in the event they are too sick to speak for themselves.\", \"slug\": \"s10-id-advance\", \"source_url\": \"https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Idaho Legislature\", \"quote\": \"(1) Any competent person aged eighteen (18) years or older may execute an advance care planning document (ACPD). Such document must contain the mandatory elements set forth in this section. Any provisions of an ACPD that are left blank by a person executing the document shall be deemed intentional and shall not invalidate the document. The department of health and welfare may create and promulgate an optional form for the ACPD. Such form is not mandatory. To be considered a valid ACPD, a document must include: (a) The person’s name, date of birth, telephone number, and mailing address; (b) The signature of the person for whom the ACPD is created or the authorized agent of such person; and (c) The date on which the document was signed.\", \"slug\": \"s10-id-execution\", \"source_url\": \"https://legislature.idaho.gov/statutesrules/idstat/Title39/T39CH45/SECT39-4510/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Idaho Legislature\", \"quote\": \"(2) An ACPD may but is not required to include the following: (a) The electronic mail address of the person executing the ACPD; (b) Nomination of one (1) or more persons to act as a health care agent; (c) The name, mailing address, electronic mail address, and telephone number of any person nominated as a health care agent, as well as such person’s relationship to the person executing the ACPD; (d) Resuscitation instructions; (e) Instructions regarding pregnancy; (g) Instructions for the release of information protected by the federal health insurance portability and accountability act; (h) Instructions for end-of-life care; (i) A description of treatment objectives; (j) The names and contact information of witnesses to the execution of the ACPD; and (k) Notarization.\", \"slug\": \"s10-id-optional-witness-notary\", \"source_url\": \"https://legislature.idaho.gov/statutesrules/idstat/Title39/T39CH45/SECT39-4510/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Idaho Department of Health and Welfare\", \"quote\": \"allows you to safely create, store, and share your Advance Directive and POST (Physician Orders for Scope of Treatment).\", \"slug\": \"s10-id-post\", \"source_url\": \"https://healthandwelfare.idaho.gov/services-programs/birth-marriage-death-records/idaho-healthcare-directive-registry\"}]", "source_urls": "https://healthandwelfare.idaho.gov/services-programs/birth-marriage-death-records/idaho-healthcare-directive-registry; https://legislature.idaho.gov/statutesrules/idstat/Title39/T39CH45/SECT39-4510/; https://www.ag.idaho.gov/office-resources/advance-directives-and-registry-services/", "state": "Idaho" }, { "advance": "Statutory short form power of attorney for health care", "advance_url": "https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf", "checked_on": "2026-10-22", "code": "IL", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-il-advance\"], \"text\": \"Statutory short form power of attorney for health care\", \"url\": \"https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf\"}, \"execution\": {\"facts\": [\"s10-il-execution\"], \"quote\": true, \"text\": \"(i) Sign the form in front of a witness. See the form for a list of who can and cannot witness it. (ii) Ask the witness to sign it, too. (iii) There is no need to have the form notarized.\", \"url\": \"https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html\"}, \"polst\": {\"facts\": [\"s10-il-polst\"], \"text\": \"Practitioner Orders for Life-Sustaining Treatment\", \"url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html\"}}, \"facts\": [\"s10-il-advance\", \"s10-il-execution\", \"s10-il-nonstatutory-exception\", \"s10-il-polst\", \"s10-il-witness-qualifications\"], \"id\": \"il\", \"notes\": [{\"facts\": [\"s10-il-execution\", \"s10-il-witness-qualifications\"], \"text\": \"The quoted rule concerns the statutory health care form. Its witness must satisfy the full age and disqualification rules.\"}, {\"facts\": [\"s10-il-nonstatutory-exception\"], \"text\": \"The source describes a separate qualifying nonstatutory health care power that need not be witnessed.\"}], \"office_url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html\", \"state\": \"Illinois\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The quoted rule concerns the statutory health care form. Its witness must satisfy the full age and disqualification rules. The source describes a separate qualifying nonstatutory health care power that need not be witnessed.", "execution": "(i) Sign the form in front of a witness. See the form for a list of who can and cannot witness it. (ii) Ask the witness to sign it, too. (iii) There is no need to have the form notarized.", "execution_url": "https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf", "fact_slugs": "s10-il-advance; s10-il-execution; s10-il-nonstatutory-exception; s10-il-polst; s10-il-witness-qualifications", "financial": "Not published", "financial_url": "https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html", "next_check_on": "2027-01-22", "office_url": "https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html", "polst": "Practitioner Orders for Life-Sustaining Treatment", "polst_url": "https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html", "publishers": "Illinois Department of Public Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Illinois Department of Public Health\", \"quote\": \"Illinois Statutory Short Form Power of Attorney for Health Care NOTICE TO THE INDIVIDUAL SIGNING THE POWER OF ATTORNEY FOR HEALTH CARE No one can predict when a serious illness or accident might occur. When it does, you may need someone else to speak or make health care decisions for you. If you plan now, you can increase the chances that the medical treatment you get will be the treatment you want.\", \"slug\": \"s10-il-advance\", \"source_url\": \"https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Illinois Department of Public Health\", \"quote\": \"(i) Sign the form in front of a witness. See the form for a list of who can and cannot witness it. (ii) Ask the witness to sign it, too. (iii) There is no need to have the form notarized.\", \"slug\": \"s10-il-execution\", \"source_url\": \"https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Illinois Department of Public Health\", \"quote\": \"In the event you do not want to use the Illinois statutory form provided here, any document you complete must be executed by you, designate an agent who is over 18 years of age and not prohibited from serving as your agent, and state the agent's powers, but it need not be witnessed or conform in any other respect to the statutory health care power.\", \"slug\": \"s10-il-nonstatutory-exception\", \"source_url\": \"https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Illinois Department of Public Health\", \"quote\": \"The Department of Public Health has published a Uniform POLST Order that is available for download here .\", \"slug\": \"s10-il-polst\", \"source_url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Illinois Department of Public Health\", \"quote\": \"I am at least 18 years old. (Check one of the options below.) I saw the principal sign this document, or the principal told me that the signature or mark on the principal signature line is his or hers. I am not the agent or successor agent(s) named in this document. I am not related to the principal, the agent, or the successor agent(s) by blood, marriage, or adoption. I am not the principal's physician, advanced practice registered nurse, dentist, podiatric physician, optometrist, psychologist, or a relative of one of those individuals. I am not an owner or operator (or the relative of an owner or operator) of the health care facility where the principal is a patient or resident.\", \"slug\": \"s10-il-witness-qualifications\", \"source_url\": \"https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf\"}]", "source_urls": "https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/powerofattorneyhealthcareform.pdf; https://dph.illinois.gov/topics-services/health-care-regulation/nursing-homes/advance-directives.html", "state": "Illinois" }, { "advance": "Health department guidance and sample-form referrals. No official or mandatory form must be followed.", "advance_url": "https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/", "checked_on": "2026-10-22", "code": "IN", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-in-advance\"], \"text\": \"Health department guidance and sample-form referrals. No official or mandatory form must be followed.\", \"url\": \"https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/\"}, \"execution\": {\"facts\": [], \"quote\": false, \"text\": \"Not published\", \"url\": \"https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/\"}, \"polst\": {\"facts\": [\"s10-in-post\"], \"text\": \"Physicians Order for Scope of Treatment\", \"url\": \"https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/\"}}, \"facts\": [\"s10-in-advance\", \"s10-in-post\"], \"id\": \"in\", \"notes\": [], \"office_url\": \"https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/\", \"state\": \"Indiana\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Not published", "execution_url": "https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/", "fact_slugs": "s10-in-advance; s10-in-post", "financial": "Not published", "financial_url": "https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/", "next_check_on": "2027-01-22", "office_url": "https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/", "polst": "Physicians Order for Scope of Treatment", "polst_url": "https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/", "publishers": "Indiana Department of Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Indiana Department of Health\", \"quote\": \"There is no official or mandatory advance directive form that must be followed, but the advance directive must meet the requirements of Indiana law to be valid.\", \"slug\": \"s10-in-advance\", \"source_url\": \"https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Indiana Department of Health\", \"quote\": \"Below is the new and updated Physicians Order for Scope of Treatment (POST) form. Physicians Order for Scope of Treatment (POST) ( PDF | Word )\", \"slug\": \"s10-in-post\", \"source_url\": \"https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/\"}]", "source_urls": "https://www.in.gov/health/cshcr/healthcare-quality-resource-center/advance-directives-resource-center/", "state": "Indiana" }, { "advance": "Durable power of attorney for health care form", "advance_url": "https://www.legis.iowa.gov/docs/code/2026/144B.5.pdf", "checked_on": "2026-10-22", "code": "IA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ia-advance\"], \"text\": \"Durable power of attorney for health care form\", \"url\": \"https://www.legis.iowa.gov/docs/code/2026/144B.5.pdf\"}, \"execution\": {\"facts\": [\"s10-ia-execution\"], \"quote\": true, \"text\": \"b. The durable power of attorney for health care contains the date of its execution and is witnessed or acknowledged by one of the following methods: (1) Is signed by at least two individuals who, in the presence of each other and the principal, witnessed the signing of the instrument by the principal or by another person acting on behalf of the principal at the principal’s direction. (2) Is acknowledged before a notarial officer within this state as provided in chapter 9B. 2. The following individuals shall not be witnesses for a durable power of attorney for health care: a. A health care provider attending the principal on the date of execution. b. An employee of a health care provider attending the principal on the date of execution. c. The individual designated in the durable power of attorney for health care as the attorney in fact. d. An individual who is less than eighteen years of age. 3. At least one of the witnesses for a durable power of attorney for health care shall be an individual who is not a relative of the principal by blood, marriage, or adoption within the third degree of consanguinity.\", \"url\": \"https://www.legis.iowa.gov/docs/code/2026/144B.3.pdf\"}, \"financial\": {\"facts\": [\"s10-ia-financial-form\"], \"text\": \"Iowa Statutory Power of Attorney form\", \"url\": \"https://www.legis.iowa.gov/docs/code/2026/633B.pdf\"}, \"polst\": {\"facts\": [\"s10-ia-ipost\"], \"text\": \"Iowa Physician Orders for Scope of Treatment\", \"url\": \"https://hhs.iowa.gov/ipost\"}}, \"facts\": [\"s10-ia-advance\", \"s10-ia-execution\", \"s10-ia-financial-form\", \"s10-ia-ipost\"], \"id\": \"ia\", \"notes\": [], \"office_url\": \"https://www.legis.iowa.gov/docs/code/2026/144B.5.pdf\", \"state\": \"Iowa\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "b. The durable power of attorney for health care contains the date of its execution and is witnessed or acknowledged by one of the following methods: (1) Is signed by at least two individuals who, in the presence of each other and the principal, witnessed the signing of the instrument by the principal or by another person acting on behalf of the principal at the principal’s direction. (2) Is acknowledged before a notarial officer within this state as provided in chapter 9B. 2. The following individuals shall not be witnesses for a durable power of attorney for health care: a. A health care provider attending the principal on the date of execution. b. An employee of a health care provider attending the principal on the date of execution. c. The individual designated in the durable power of attorney for health care as the attorney in fact. d. An individual who is less than eighteen years of age. 3. At least one of the witnesses for a durable power of attorney for health care shall be an individual who is not a relative of the principal by blood, marriage, or adoption within the third degree of consanguinity.", "execution_url": "https://www.legis.iowa.gov/docs/code/2026/144B.3.pdf", "fact_slugs": "s10-ia-advance; s10-ia-execution; s10-ia-financial-form; s10-ia-ipost", "financial": "Iowa Statutory Power of Attorney form", "financial_url": "https://www.legis.iowa.gov/docs/code/2026/633B.pdf", "next_check_on": "2027-01-22", "office_url": "https://www.legis.iowa.gov/docs/code/2026/144B.5.pdf", "polst": "Iowa Physician Orders for Scope of Treatment", "polst_url": "https://hhs.iowa.gov/ipost", "publishers": "Iowa Department of Health and Human Services; Iowa Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Iowa Legislature\", \"quote\": \"1. A durable power of attorney for health care executed pursuant to this chapter may, but need not, be in the following form:\", \"slug\": \"s10-ia-advance\", \"source_url\": \"https://www.legis.iowa.gov/docs/code/2026/144B.5.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Iowa Legislature\", \"quote\": \"b. The durable power of attorney for health care contains the date of its execution and is witnessed or acknowledged by one of the following methods: (1) Is signed by at least two individuals who, in the presence of each other and the principal, witnessed the signing of the instrument by the principal or by another person acting on behalf of the principal at the principal’s direction. (2) Is acknowledged before a notarial officer within this state as provided in chapter 9B. 2. The following individuals shall not be witnesses for a durable power of attorney for health care: a. A health care provider attending the principal on the date of execution. b. An employee of a health care provider attending the principal on the date of execution. c. The individual designated in the durable power of attorney for health care as the attorney in fact. d. An individual who is less than eighteen years of age. 3. At least one of the witnesses for a durable power of attorney for health care shall be an individual who is not a relative of the principal by blood, marriage, or adoption within the third degree of consanguinity.\", \"slug\": \"s10-ia-execution\", \"source_url\": \"https://www.legis.iowa.gov/docs/code/2026/144B.3.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Iowa Legislature\", \"quote\": \"A document substantially in the following form may be used to create a statutory power of attorney that has the meaning and effect prescribed by this chapter:\", \"slug\": \"s10-ia-financial-form\", \"source_url\": \"https://www.legis.iowa.gov/docs/code/2026/633B.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Iowa Department of Health and Human Services\", \"quote\": \"The Iowa Physician Orders for Scope of Treatment, known as IPOST, is a double-sided, one-page document that allows a person to communicate their preferences for key life-sustaining treatments including: resuscitation, general scope of treatment, artificial nutrition and more.\", \"slug\": \"s10-ia-ipost\", \"source_url\": \"https://hhs.iowa.gov/ipost\"}]", "source_urls": "https://hhs.iowa.gov/ipost; https://www.legis.iowa.gov/docs/code/2026/144B.3.pdf; https://www.legis.iowa.gov/docs/code/2026/144B.5.pdf; https://www.legis.iowa.gov/docs/code/2026/633B.pdf", "state": "Iowa" }, { "advance": "Durable power of attorney for health care decisions form", "advance_url": "https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/", "checked_on": "2026-10-22", "code": "KS", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ks-advance\"], \"text\": \"Durable power of attorney for health care decisions form\", \"url\": \"https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/\"}, \"execution\": {\"facts\": [\"s10-ks-execution\"], \"quote\": true, \"text\": \"(e) A durable power of attorney for health care decisions shall be: (1) Dated and signed in the presence of two witnesses at least 18 years of age neither of whom shall be the agent, related to the principal by blood, marriage or adoption, entitled to any portion of the estate of the principal according to the laws of intestate succession of this state or under any will of the principal or codicil thereto, or directly financially responsible for the principal's health care; or (2) acknowledged before a notary public.\", \"url\": \"https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0029_section/058_006_0029_k/\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/\"}, \"polst\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/\"}}, \"facts\": [\"s10-ks-advance\", \"s10-ks-execution\"], \"id\": \"ks\", \"notes\": [], \"office_url\": \"https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/\", \"state\": \"Kansas\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "(e) A durable power of attorney for health care decisions shall be: (1) Dated and signed in the presence of two witnesses at least 18 years of age neither of whom shall be the agent, related to the principal by blood, marriage or adoption, entitled to any portion of the estate of the principal according to the laws of intestate succession of this state or under any will of the principal or codicil thereto, or directly financially responsible for the principal's health care; or (2) acknowledged before a notary public.", "execution_url": "https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0029_section/058_006_0029_k/", "fact_slugs": "s10-ks-advance; s10-ks-execution", "financial": "Not published", "financial_url": "https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/", "next_check_on": "2027-01-22", "office_url": "https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/", "polst": "Not published", "polst_url": "https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/", "publishers": "Kansas Legislature, Office of Revisor of Statutes", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Kansas Legislature, Office of Revisor of Statutes\", \"quote\": \"A durable power of attorney for health care decisions shall be in substantially the following form:\", \"slug\": \"s10-ks-advance\", \"source_url\": \"https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Kansas Legislature, Office of Revisor of Statutes\", \"quote\": \"(e) A durable power of attorney for health care decisions shall be: (1) Dated and signed in the presence of two witnesses at least 18 years of age neither of whom shall be the agent, related to the principal by blood, marriage or adoption, entitled to any portion of the estate of the principal according to the laws of intestate succession of this state or under any will of the principal or codicil thereto, or directly financially responsible for the principal's health care; or (2) acknowledged before a notary public.\", \"slug\": \"s10-ks-execution\", \"source_url\": \"https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0029_section/058_006_0029_k/\"}]", "source_urls": "https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0029_section/058_006_0029_k/; https://kslegislature.gov/b2023_24/laws/058_000_0000_chapter/058_006_0000_article/058_006_0032_section/058_006_0032_k/", "state": "Kansas" }, { "advance": "Statutory Living Will Directive. KRS 311.625", "advance_url": "https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591", "checked_on": "2026-10-22", "code": "KY", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ky-advance\"], \"text\": \"Statutory Living Will Directive. KRS 311.625\", \"url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591\"}, \"execution\": {\"facts\": [\"s10-ky-execution\"], \"quote\": true, \"text\": \"An advance directive shall be in writing, dated, and signed by the grantor, or at the grantor's direction, and either witnessed by two (2) or more adults in the presence of the grantor and in the presence of each other, or acknowledged before a notary public or other person authorized to administer oaths. None of the following shall be a witness to or serve as a notary public or other person authorized to administer oaths in regard to any advance directive made under this section: (a) A blood relative of the grantor; (b) A beneficiary of the grantor under descent and distribution statutes of the Commonwealth; (c) An employee of a health care facility in which the grantor is a patient, unless the employee serves as a notary public; (d) An attending physician of the grantor; or (e) Any person directly financially responsible for the grantor's health care.\", \"url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591\"}, \"financial\": {\"facts\": [\"s10-ky-financial\"], \"text\": \"Statutory Form Power of Attorney. KRS 457.420\", \"url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50172\"}, \"polst\": {\"facts\": [\"s10-ky-polst\"], \"text\": \"Medical Orders for Scope of Treatment (MOST)\", \"url\": \"https://apps.legislature.ky.gov/law/kar/titles/201/009/470/\"}}, \"facts\": [\"s10-ky-advance\", \"s10-ky-execution\", \"s10-ky-financial\", \"s10-ky-polst\"], \"id\": \"ky\", \"notes\": [], \"office_url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591\", \"state\": \"Kentucky\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "An advance directive shall be in writing, dated, and signed by the grantor, or at the grantor's direction, and either witnessed by two (2) or more adults in the presence of the grantor and in the presence of each other, or acknowledged before a notary public or other person authorized to administer oaths. None of the following shall be a witness to or serve as a notary public or other person authorized to administer oaths in regard to any advance directive made under this section: (a) A blood relative of the grantor; (b) A beneficiary of the grantor under descent and distribution statutes of the Commonwealth; (c) An employee of a health care facility in which the grantor is a patient, unless the employee serves as a notary public; (d) An attending physician of the grantor; or (e) Any person directly financially responsible for the grantor's health care.", "execution_url": "https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591", "fact_slugs": "s10-ky-advance; s10-ky-execution; s10-ky-financial; s10-ky-polst", "financial": "Statutory Form Power of Attorney. KRS 457.420", "financial_url": "https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50172", "next_check_on": "2027-01-22", "office_url": "https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591", "polst": "Medical Orders for Scope of Treatment (MOST)", "polst_url": "https://apps.legislature.ky.gov/law/kar/titles/201/009/470/", "publishers": "Kentucky General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Kentucky General Assembly\", \"quote\": \"A living will directive made pursuant to KRS 311.623 shall be substantially in the following form, and may include other specific directions which are in accordance with accepted medical practice and not specifically prohibited by any other statute.\", \"slug\": \"s10-ky-advance\", \"source_url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Kentucky General Assembly\", \"quote\": \"An advance directive shall be in writing, dated, and signed by the grantor, or at the grantor's direction, and either witnessed by two (2) or more adults in the presence of the grantor and in the presence of each other, or acknowledged before a notary public or other person authorized to administer oaths. None of the following shall be a witness to or serve as a notary public or other person authorized to administer oaths in regard to any advance directive made under this section: (a) A blood relative of the grantor; (b) A beneficiary of the grantor under descent and distribution statutes of the Commonwealth; (c) An employee of a health care facility in which the grantor is a patient, unless the employee serves as a notary public; (d) An attending physician of the grantor; or (e) Any person directly financially responsible for the grantor's health care.\", \"slug\": \"s10-ky-execution\", \"source_url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Kentucky General Assembly\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by this chapter: KENTUCKY STATUTORY FORM POWER OF ATTORNEY IMPORTANT INFORMATION This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself. The meaning of authority over subjects listed on this form is explained in the Uniform Power of Attorney Act in KRS Chapter 457. This power of attorney does not authorize the agent to make health-care decisions for you.\", \"slug\": \"s10-ky-financial\", \"source_url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50172\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Kentucky General Assembly\", \"quote\": \"\\\"MOST, Medical Orders for Scope of Treatment\\\", June 2022; and (b) \\\"MOST Form Spanish\\\", June 2022.\", \"slug\": \"s10-ky-polst\", \"source_url\": \"https://apps.legislature.ky.gov/law/kar/titles/201/009/470/\"}]", "source_urls": "https://apps.legislature.ky.gov/law/kar/titles/201/009/470/; https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=42591; https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50172", "state": "Kentucky" }, { "advance": "Illustrative declaration concerning life-sustaining procedures. R.S. 40 section 1151.2", "advance_url": "https://www.legis.la.gov/Legis/Law.aspx?d=964664", "checked_on": "2026-10-22", "code": "LA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-la-advance\"], \"text\": \"Illustrative declaration concerning life-sustaining procedures. R.S. 40 section 1151.2\", \"url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964664\"}, \"execution\": {\"facts\": [\"s10-la-execution\"], \"quote\": true, \"text\": \"A written declaration shall be signed by the declarant in the presence of two witnesses.\", \"url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964664\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.legis.la.gov/legis/Law.aspx?d=110025\"}, \"polst\": {\"facts\": [\"s10-la-polst\"], \"text\": \"Louisiana Physician Order for Scope of Treatment (LaPOST)\", \"url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964688\"}}, \"facts\": [\"s10-la-advance\", \"s10-la-execution\", \"s10-la-polst\", \"s10-la-witness-scope\"], \"id\": \"la\", \"notes\": [{\"facts\": [\"s10-la-witness-scope\"], \"text\": \"This is the written declaration rule. Witnesses must be competent adults who are unrelated by blood or marriage and have no entitlement to the relevant estate.\"}], \"office_url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964664\", \"state\": \"Louisiana\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. This is the written declaration rule. Witnesses must be competent adults who are unrelated by blood or marriage and have no entitlement to the relevant estate.", "execution": "A written declaration shall be signed by the declarant in the presence of two witnesses.", "execution_url": "https://www.legis.la.gov/Legis/Law.aspx?d=964664", "fact_slugs": "s10-la-advance; s10-la-execution; s10-la-polst; s10-la-witness-scope", "financial": "Not published", "financial_url": "https://www.legis.la.gov/legis/Law.aspx?d=110025", "next_check_on": "2027-01-22", "office_url": "https://www.legis.la.gov/Legis/Law.aspx?d=964664", "polst": "Louisiana Physician Order for Scope of Treatment (LaPOST)", "polst_url": "https://www.legis.la.gov/Legis/Law.aspx?d=964688", "publishers": "Louisiana State Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Louisiana State Legislature\", \"quote\": \"The declaration may, but need not, be in the following illustrative form\", \"slug\": \"s10-la-advance\", \"source_url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964664\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Louisiana State Legislature\", \"quote\": \"A written declaration shall be signed by the declarant in the presence of two witnesses.\", \"slug\": \"s10-la-execution\", \"source_url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964664\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Louisiana State Legislature\", \"quote\": \"The secretary of the Louisiana Department of Health is hereby authorized and directed to promulgate and publish rules, regulations, and standards, in accordance with the Administrative Procedure Act, to provide for the Louisiana Physician Order for Scope of Treatment \\\"LaPOST\\\" program.\", \"slug\": \"s10-la-polst\", \"source_url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964688\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Louisiana State Legislature\", \"quote\": \"\\\"Witness\\\" means a competent adult who is not related to the declarant or qualified patient, whichever is applicable, by blood or marriage and who would not be entitled to any portion of the estate of the person from whom life-sustaining procedures are to be withheld or withdrawn upon his decease.\", \"slug\": \"s10-la-witness-scope\", \"source_url\": \"https://www.legis.la.gov/Legis/Law.aspx?d=964663\"}]", "source_urls": "https://www.legis.la.gov/Legis/Law.aspx?d=964663; https://www.legis.la.gov/Legis/Law.aspx?d=964664; https://www.legis.la.gov/Legis/Law.aspx?d=964688", "state": "Louisiana" }, { "advance": "Optional Advance Health Care Directive. Title 18-C section 5-805", "advance_url": "https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf", "checked_on": "2026-10-22", "code": "ME", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-me-advance\"], \"text\": \"Optional Advance Health Care Directive. Title 18-C section 5-805\", \"url\": \"https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf\"}, \"execution\": {\"facts\": [\"s10-me-execution\"], \"quote\": true, \"text\": \"The power must be in writing and signed by the principal and 2 witnesses. Notwithstanding any law validating electronic or digital signatures, signatures of the principal and witnesses must be made in person and not by electronic means.\", \"url\": \"https://legislature.maine.gov/statutes/18-c/title18-Csec5-803.html\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://legislature.maine.gov/statutes/18-C/title18-Csec5-905.html\"}, \"polst\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf\"}}, \"facts\": [\"s10-me-advance\", \"s10-me-execution\", \"s10-me-remote-exception\"], \"id\": \"me\", \"notes\": [{\"facts\": [\"s10-me-remote-exception\", \"s10-me-execution\"], \"text\": \"The quoted rule concerns the health care power of attorney. A separate statute permits a narrow remote-signing process for infectious-disease isolation in a hospital or residential health care facility.\"}], \"office_url\": \"https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf\", \"state\": \"Maine\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The quoted rule concerns the health care power of attorney. A separate statute permits a narrow remote-signing process for infectious-disease isolation in a hospital or residential health care facility.", "execution": "The power must be in writing and signed by the principal and 2 witnesses. Notwithstanding any law validating electronic or digital signatures, signatures of the principal and witnesses must be made in person and not by electronic means.", "execution_url": "https://legislature.maine.gov/statutes/18-c/title18-Csec5-803.html", "fact_slugs": "s10-me-advance; s10-me-execution; s10-me-remote-exception", "financial": "Not published", "financial_url": "https://legislature.maine.gov/statutes/18-C/title18-Csec5-905.html", "next_check_on": "2027-01-22", "office_url": "https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf", "polst": "Not published", "polst_url": "https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf", "publishers": "Maine Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maine Legislature\", \"quote\": \"The following form may, but need not, be used to create an advance health care directive. The other sections of this Part govern the effect of this or any other writing used to create an advance health care directive. An individual with capacity may complete or modify all or any part of the following form.\", \"slug\": \"s10-me-advance\", \"source_url\": \"https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maine Legislature\", \"quote\": \"The power must be in writing and signed by the principal and 2 witnesses. Notwithstanding any law validating electronic or digital signatures, signatures of the principal and witnesses must be made in person and not by electronic means.\", \"slug\": \"s10-me-execution\", \"source_url\": \"https://legislature.maine.gov/statutes/18-c/title18-Csec5-803.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maine Legislature\", \"quote\": \"When a principal in a hospital or a residential health care facility has an infectious disease and is confined to a room or ward where isolation precautions prevent the physical presence of individuals or documents necessary for executing the principal's advance health care directives, staff, employees and agents of a hospital or a residential health care facility where the principal is located may assist and facilitate the execution of advance health care directives using the process provided in this section.\", \"slug\": \"s10-me-remote-exception\", \"source_url\": \"https://legislature.maine.gov/statutes/18-C/title18-Csec5-803-A.html\"}]", "source_urls": "https://legislature.maine.gov/statutes/18-C/title18-Csec5-803-A.html; https://legislature.maine.gov/statutes/18-C/title18-Csec5-805.pdf; https://legislature.maine.gov/statutes/18-c/title18-Csec5-803.html", "state": "Maine" }, { "advance": "Maryland Advance Directive form and instructions", "advance_url": "https://health.maryland.gov/phpa/ccdb/ADP/Pages/Individual-Resources.aspx", "checked_on": "2026-10-22", "code": "MD", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-md-advance\"], \"text\": \"Maryland Advance Directive form and instructions\", \"url\": \"https://health.maryland.gov/phpa/ccdb/ADP/Pages/Individual-Resources.aspx\"}, \"execution\": {\"facts\": [\"s10-md-execution\"], \"quote\": true, \"text\": \"Except as provided in subparagraph (ii) of this paragraph or paragraph (3) of this subsection, a written or electronic advance directive shall be dated, signed by or at the express direction of the declarant, and subscribed by two witnesses in the physical presence or electronic presence of the declarant.\", \"url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=5-602\"}, \"financial\": {\"facts\": [\"s10-md-financial\"], \"text\": \"Statutory Personal Financial Power of Attorney. Estates and Trusts section 17-202\", \"url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=get§ion=17-202\"}, \"polst\": {\"facts\": [\"s10-md-polst\"], \"text\": \"Medical Orders for Life-Sustaining Treatment (MOLST)\", \"url\": \"https://health.maryland.gov/phpa/ccdb/ADP/Pages/Physician-Resources---Adv-Care.aspx\"}}, \"facts\": [\"s10-md-advance\", \"s10-md-execution\", \"s10-md-financial\", \"s10-md-polst\", \"s10-md-video-exception\", \"s10-md-witness-scope\"], \"id\": \"md\", \"notes\": [{\"facts\": [\"s10-md-witness-scope\"], \"text\": \"The health care agent cannot witness. At least one witness must lack a known estate entitlement or financial benefit at death.\"}, {\"facts\": [\"s10-md-video-exception\", \"s10-md-execution\"], \"text\": \"The linked statute includes an unwitnessed video exception and recognizes directives executed during the specified earlier emergency order. Check the complete statute with a lawyer.\"}], \"office_url\": \"https://health.maryland.gov/phpa/ccdb/ADP/Pages/Individual-Resources.aspx\", \"state\": \"Maryland\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The health care agent cannot witness. At least one witness must lack a known estate entitlement or financial benefit at death. The linked statute includes an unwitnessed video exception and recognizes directives executed during the specified earlier emergency order. Check the complete statute with a lawyer.", "execution": "Except as provided in subparagraph (ii) of this paragraph or paragraph (3) of this subsection, a written or electronic advance directive shall be dated, signed by or at the express direction of the declarant, and subscribed by two witnesses in the physical presence or electronic presence of the declarant.", "execution_url": "https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=5-602", "fact_slugs": "s10-md-advance; s10-md-execution; s10-md-financial; s10-md-polst; s10-md-video-exception; s10-md-witness-scope", "financial": "Statutory Personal Financial Power of Attorney. Estates and Trusts section 17-202", "financial_url": "https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=get§ion=17-202", "next_check_on": "2027-01-22", "office_url": "https://health.maryland.gov/phpa/ccdb/ADP/Pages/Individual-Resources.aspx", "polst": "Medical Orders for Life-Sustaining Treatment (MOLST)", "polst_url": "https://health.maryland.gov/phpa/ccdb/ADP/Pages/Physician-Resources---Adv-Care.aspx", "publishers": "Maryland Department of Health; Maryland General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maryland Department of Health\", \"quote\": \"If you choose to do your advance directive on paper, use the links below to download an advance directive form and instructions.\", \"slug\": \"s10-md-advance\", \"source_url\": \"https://health.maryland.gov/phpa/ccdb/ADP/Pages/Individual-Resources.aspx\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maryland General Assembly\", \"quote\": \"Except as provided in subparagraph (ii) of this paragraph or paragraph (3) of this subsection, a written or electronic advance directive shall be dated, signed by or at the express direction of the declarant, and subscribed by two witnesses in the physical presence or electronic presence of the declarant.\", \"slug\": \"s10-md-execution\", \"source_url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=5-602\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maryland General Assembly\", \"quote\": \"MARYLAND STATUTORY FORM PERSONAL FINANCIAL POWER OF ATTORNEY IMPORTANT INFORMATION AND WARNING You should be very careful in deciding whether or not to sign this document. The powers granted by you (the principal) in this document are broad and sweeping. This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself.\", \"slug\": \"s10-md-financial\", \"source_url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=get§ion=17-202\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maryland Department of Health\", \"quote\": \"Medical Orders for Life-Sustaining Treatment (MOLST) A MOLST is different from an advance directive. A MOLST can be created by licensed physicians, nurse practitioners, and physician assistants. A MOLST contains specific medical orders for the patient’s current condition.\", \"slug\": \"s10-md-polst\", \"source_url\": \"https://health.maryland.gov/phpa/ccdb/ADP/Pages/Physician-Resources---Adv-Care.aspx\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maryland General Assembly\", \"quote\": \"The State–designated health information exchange may accept as valid an unwitnessed electronic advance directive in the form of a video record or file to state the declarant’s wishes regarding health care for the declarant or to appoint an agent if the video record or file: (i) Is dated; and (ii) Is stored in an electronic file by an electronic advance directives service recognized by the Maryland Health Care Commission. A written or electronic advance directive signed and witnessed in conformance with the provisions of Executive Order 20.04.10.01, authorizing remote witnessing and electronic signing of certain documents, shall be deemed to have been signed and witnessed in conformity with this subsection if the advance directive was signed and witnessed during the time that the executive order was in effect.\", \"slug\": \"s10-md-video-exception\", \"source_url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=5-602\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Maryland General Assembly\", \"quote\": \"Except as provided in subparagraphs (ii) and (iii) of this paragraph, any competent individual may serve as a witness to an advance directive, including an employee of a health care facility, nurse practitioner, physician assistant, or physician caring for the declarant if acting in good faith. (ii) The health care agent of the declarant may not serve as a witness. (iii) At least one of the witnesses must be an individual who is not knowingly entitled to any portion of the estate of the declarant or knowingly entitled to any financial benefit by reason of the death of the declarant.\", \"slug\": \"s10-md-witness-scope\", \"source_url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=5-602\"}]", "source_urls": "https://health.maryland.gov/phpa/ccdb/ADP/Pages/Individual-Resources.aspx; https://health.maryland.gov/phpa/ccdb/ADP/Pages/Physician-Resources---Adv-Care.aspx; https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=get§ion=17-202; https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=5-602", "state": "Maryland" }, { "advance": "DPH Health Care Proxy form resources", "advance_url": "https://www.mass.gov/doc/dph-letter-health-care-proxy-and-personal-directive-living-will-june-3-2026/download", "checked_on": "2026-10-22", "code": "MA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ma-advance\"], \"text\": \"DPH Health Care Proxy form resources\", \"url\": \"https://www.mass.gov/doc/dph-letter-health-care-proxy-and-personal-directive-living-will-june-3-2026/download\"}, \"execution\": {\"facts\": [\"s10-ma-execution\"], \"quote\": true, \"text\": \"Said health care proxy shall be in writing signed by such adult or at the direction of such adult in the presence of two other adults who shall subscribe their names as witnesses to such signature. The witnesses shall affirm in writing that the principal appeared to be at least eighteen years of age, of sound mind and under no constraint or undue influence. No person who has been named as health care agent in a health care proxy shall act as a witness to the execution of such proxy. For the purposes of this section, every adult shall be presumed to be competent and every health care proxy shall be presumed to be properly executed unless a court determines otherwise.\", \"url\": \"https://malegislature.gov/laws/generallaws/partii/titleii/chapter201d/section2\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.mass.gov/info-details/mass-general-laws-c190b-article-v-part-5-prefatory-note\"}, \"polst\": {\"facts\": [\"s10-ma-polst\", \"s10-ma-polst-transition\"], \"text\": \"Medical Orders for Life-Sustaining Treatment (MOLST). POLST transition\", \"url\": \"https://www.mass.gov/orgs/molst-subcommittee\"}}, \"facts\": [\"s10-ma-advance\", \"s10-ma-execution\", \"s10-ma-polst\", \"s10-ma-polst-transition\"], \"id\": \"ma\", \"notes\": [{\"facts\": [\"s10-ma-advance\", \"s10-ma-execution\"], \"text\": \"DPH offers partner-provided forms. The quoted execution rule concerns the health care proxy.\"}, {\"facts\": [\"s10-ma-polst\", \"s10-ma-polst-transition\"], \"text\": \"The legislature directs a transition from MOLST to the national POLST model. Follow the DPH program referral for current form guidance.\"}], \"office_url\": \"https://www.mass.gov/doc/dph-letter-health-care-proxy-and-personal-directive-living-will-june-3-2026/download\", \"state\": \"Massachusetts\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. DPH offers partner-provided forms. The quoted execution rule concerns the health care proxy. The legislature directs a transition from MOLST to the national POLST model. Follow the DPH program referral for current form guidance.", "execution": "Said health care proxy shall be in writing signed by such adult or at the direction of such adult in the presence of two other adults who shall subscribe their names as witnesses to such signature. The witnesses shall affirm in writing that the principal appeared to be at least eighteen years of age, of sound mind and under no constraint or undue influence. No person who has been named as health care agent in a health care proxy shall act as a witness to the execution of such proxy. For the purposes of this section, every adult shall be presumed to be competent and every health care proxy shall be presumed to be properly executed unless a court determines otherwise.", "execution_url": "https://malegislature.gov/laws/generallaws/partii/titleii/chapter201d/section2", "fact_slugs": "s10-ma-advance; s10-ma-execution; s10-ma-polst; s10-ma-polst-transition", "financial": "Not published", "financial_url": "https://www.mass.gov/info-details/mass-general-laws-c190b-article-v-part-5-prefatory-note", "next_check_on": "2027-01-22", "office_url": "https://www.mass.gov/doc/dph-letter-health-care-proxy-and-personal-directive-living-will-june-3-2026/download", "polst": "Medical Orders for Life-Sustaining Treatment (MOLST). POLST transition", "polst_url": "https://www.mass.gov/orgs/molst-subcommittee", "publishers": "Massachusetts Department of Public Health; Massachusetts Department of Public Health, MOLST Subcommittee; Massachusetts General Court", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Massachusetts Department of Public Health\", \"quote\": \"DPH is partnering with Honoring Choices Massachusetts and the Massachusetts Health & Hospital Association to offer a free multilingual Health Care Proxy and Personal Directive (Living Will).\", \"slug\": \"s10-ma-advance\", \"source_url\": \"https://www.mass.gov/doc/dph-letter-health-care-proxy-and-personal-directive-living-will-june-3-2026/download\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Massachusetts General Court\", \"quote\": \"Said health care proxy shall be in writing signed by such adult or at the direction of such adult in the presence of two other adults who shall subscribe their names as witnesses to such signature. The witnesses shall affirm in writing that the principal appeared to be at least eighteen years of age, of sound mind and under no constraint or undue influence. No person who has been named as health care agent in a health care proxy shall act as a witness to the execution of such proxy. For the purposes of this section, every adult shall be presumed to be competent and every health care proxy shall be presumed to be properly executed unless a court determines otherwise.\", \"slug\": \"s10-ma-execution\", \"source_url\": \"https://malegislature.gov/laws/generallaws/partii/titleii/chapter201d/section2\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Massachusetts Department of Public Health, MOLST Subcommittee\", \"quote\": \"The Medical Orders of Life Sustaining Treatment (MOLST) Subcommittee advises on updates to the MOLST form. We work with the Palliative Care and Quality of Life Interdisciplinary Advisory Council and the Department of Public Health (DPH).\", \"slug\": \"s10-ma-polst\", \"source_url\": \"https://www.mass.gov/orgs/molst-subcommittee\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Massachusetts General Court\", \"quote\": \"The POLST program shall transition from the use of medical orders for life-sustaining treatment, also known as MOLST, to the national POLST model.\", \"slug\": \"s10-ma-polst-transition\", \"source_url\": \"https://malegislature.gov/Laws/GeneralLaws/PartI/TitleII/Chapter19A/Section44\"}]", "source_urls": "https://malegislature.gov/Laws/GeneralLaws/PartI/TitleII/Chapter19A/Section44; https://malegislature.gov/laws/generallaws/partii/titleii/chapter201d/section2; https://www.mass.gov/doc/dph-letter-health-care-proxy-and-personal-directive-living-will-june-3-2026/download; https://www.mass.gov/orgs/molst-subcommittee", "state": "Massachusetts" }, { "advance": "Attorney General referrals for patient advocate and medical power of attorney forms", "advance_url": "https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force", "checked_on": "2026-10-22", "code": "MI", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-mi-advance\"], \"text\": \"Attorney General referrals for patient advocate and medical power of attorney forms\", \"url\": \"https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force\"}, \"execution\": {\"facts\": [], \"quote\": true, \"text\": \"Not published\", \"url\": \"https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force\"}, \"financial\": {\"facts\": [\"s10-mi-financial\"], \"text\": \"Michigan Statutory Form Power of Attorney\", \"url\": \"https://www.michigan.gov/ag/-/media/Project/Websites/AG/EATF/Michigan-Statutory-Form-Power-of-Attorney.pdf?rev=6c4825f9d4814c1a843c524d7c4efe91\"}, \"polst\": {\"facts\": [\"s10-mi-polst\"], \"text\": \"Michigan Physician Orders for Scope of Treatment (MI-POST)\", \"url\": \"https://www.michigan.gov/en/mdhhs/inside-mdhhs/legislationpolicy/ems/news/mi-post\"}}, \"facts\": [\"s10-mi-advance\", \"s10-mi-financial\", \"s10-mi-polst\"], \"id\": \"mi\", \"notes\": [{\"facts\": [\"s10-mi-advance\"], \"text\": \"The advance-directive links are Attorney General referrals to forms from other organizations.\"}], \"office_url\": \"https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force\", \"state\": \"Michigan\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The advance-directive links are Attorney General referrals to forms from other organizations.", "execution": "Not published", "execution_url": "https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force", "fact_slugs": "s10-mi-advance; s10-mi-financial; s10-mi-polst", "financial": "Michigan Statutory Form Power of Attorney", "financial_url": "https://www.michigan.gov/ag/-/media/Project/Websites/AG/EATF/Michigan-Statutory-Form-Power-of-Attorney.pdf?rev=6c4825f9d4814c1a843c524d7c4efe91", "next_check_on": "2027-01-22", "office_url": "https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force", "polst": "Michigan Physician Orders for Scope of Treatment (MI-POST)", "polst_url": "https://www.michigan.gov/en/mdhhs/inside-mdhhs/legislationpolicy/ems/news/mi-post", "publishers": "Michigan Department of Attorney General; Michigan Department of Health and Human Services", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Michigan Department of Attorney General\", \"quote\": \"Downloadable, easy-to-use versions of a financial power of attorney and medical power of attorney are available below. The Kimble Center for Legal Drafting offers the Finances Power of Attorney and the Medical Power of Attorney form as a public service.\", \"slug\": \"s10-mi-advance\", \"source_url\": \"https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Michigan Department of Attorney General\", \"quote\": \"MICHIGAN STATUTORY FORM POWER OF ATTORNEY IMPORTANT INFORMATION This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). It is, therefore, an important legal document, and you are taking a serious step if you decide to make use of this form without seeking legal advice; for if the person you designate as your agent accepts authority granted under this power of attorney, the agent will be able to make decisions and act with respect to your property (including your money). The extent of your agent's authority over subjects listed on this form is explained in the uniform power of attorney act, MCL 556.201 to 556.505.\", \"slug\": \"s10-mi-financial\", \"source_url\": \"https://www.michigan.gov/ag/-/media/Project/Websites/AG/EATF/Michigan-Statutory-Form-Power-of-Attorney.pdf?rev=6c4825f9d4814c1a843c524d7c4efe91\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Michigan Department of Health and Human Services\", \"quote\": \"Michigan Physician Orders for Scope of Treatment (MI-POST) MI-POST is an optional, 1 page, 2-sided medical order with a person's wished for care in a crisis. The intended population is people with serious advanced illness or frailty. MI-POST is a part of the advance care planning process that included choices about cardiopulmonary resuscitation (CPR), critical care, and other wanted care. It is intended to guide care only if the person cannot tell others what to do at that time. MI-POST is signed by the patient/patient representative and their physician, nurse practitioner, or physician's assistant.\", \"slug\": \"s10-mi-polst\", \"source_url\": \"https://www.michigan.gov/en/mdhhs/inside-mdhhs/legislationpolicy/ems/news/mi-post\"}]", "source_urls": "https://www.michigan.gov/ag/-/media/Project/Websites/AG/EATF/Michigan-Statutory-Form-Power-of-Attorney.pdf?rev=6c4825f9d4814c1a843c524d7c4efe91; https://www.michigan.gov/ag/initiatives/elder-abuse/elder-abuse-task-force; https://www.michigan.gov/en/mdhhs/inside-mdhhs/legislationpolicy/ems/news/mi-post", "state": "Michigan" }, { "advance": "Suggested Health Care Directive. Minnesota Statutes 145C.16", "advance_url": "https://www.revisor.mn.gov/statutes/cite/145C.16/pdf", "checked_on": "2026-10-22", "code": "MN", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-mn-advance\"], \"text\": \"Suggested Health Care Directive. Minnesota Statutes 145C.16\", \"url\": \"https://www.revisor.mn.gov/statutes/cite/145C.16/pdf\"}, \"execution\": {\"facts\": [\"s10-mn-execution\"], \"quote\": true, \"text\": \"This document must be signed by me. It also must either be verified by a notary public (Option 1) OR​ witnessed by two witnesses (Option 2). It must be dated when it is verified or witnessed.​\", \"url\": \"https://www.revisor.mn.gov/statutes/cite/145C.16/pdf\"}, \"financial\": {\"facts\": [\"s10-mn-financial\"], \"text\": \"Statutory Short Form Power of Attorney. Minnesota Statutes 523.23\", \"url\": \"https://www.revisor.mn.gov/statutes/cite/523/full\"}, \"polst\": {\"facts\": [\"s10-mn-polst\"], \"text\": \"Provider Orders for Life-Sustaining Treatment (POLST)\", \"url\": \"https://www.health.mn.gov/people/palliative/advcareplan.html\"}}, \"facts\": [\"s10-mn-advance\", \"s10-mn-execution\", \"s10-mn-financial\", \"s10-mn-polst\", \"s10-mn-witness-scope\"], \"id\": \"mn\", \"notes\": [{\"facts\": [\"s10-mn-witness-scope\"], \"text\": \"The notary cannot be a named agent or alternate. Witnesses must be adults and cannot be named agents or alternates. Only one witness may provide direct care or work for a provider giving direct care that day.\"}], \"office_url\": \"https://www.revisor.mn.gov/statutes/cite/145C.16/pdf\", \"state\": \"Minnesota\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The notary cannot be a named agent or alternate. Witnesses must be adults and cannot be named agents or alternates. Only one witness may provide direct care or work for a provider giving direct care that day.", "execution": "This document must be signed by me. It also must either be verified by a notary public (Option 1) OR​ witnessed by two witnesses (Option 2). It must be dated when it is verified or witnessed.​", "execution_url": "https://www.revisor.mn.gov/statutes/cite/145C.16/pdf", "fact_slugs": "s10-mn-advance; s10-mn-execution; s10-mn-financial; s10-mn-polst; s10-mn-witness-scope", "financial": "Statutory Short Form Power of Attorney. Minnesota Statutes 523.23", "financial_url": "https://www.revisor.mn.gov/statutes/cite/523/full", "next_check_on": "2027-01-22", "office_url": "https://www.revisor.mn.gov/statutes/cite/145C.16/pdf", "polst": "Provider Orders for Life-Sustaining Treatment (POLST)", "polst_url": "https://www.health.mn.gov/people/palliative/advcareplan.html", "publishers": "Minnesota Department of Health; Minnesota Legislature, Office of the Revisor of Statutes", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Minnesota Legislature, Office of the Revisor of Statutes\", \"quote\": \"145C.16 SUGGESTED FORM.\", \"slug\": \"s10-mn-advance\", \"source_url\": \"https://www.revisor.mn.gov/statutes/cite/145C.16/pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Minnesota Legislature, Office of the Revisor of Statutes\", \"quote\": \"This document must be signed by me. It also must either be verified by a notary public (Option 1) OR​ witnessed by two witnesses (Option 2). It must be dated when it is verified or witnessed.​\", \"slug\": \"s10-mn-execution\", \"source_url\": \"https://www.revisor.mn.gov/statutes/cite/145C.16/pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Minnesota Legislature, Office of the Revisor of Statutes\", \"quote\": \"The following form may be used to create a power of attorney, and, when used, it must be construed in accordance with sections 523.23 and 523.24 : STATUTORY SHORT FORM POWER OF ATTORNEY MINNESOTA STATUTES, SECTION 523.23\", \"slug\": \"s10-mn-financial\", \"source_url\": \"https://www.revisor.mn.gov/statutes/cite/523/full\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Minnesota Department of Health\", \"quote\": \"Provider Orders for Life-Sustaining Treatment (POLST) This form is most helpful and used often when someone is outside of the hospital. It is a medical provider's order which must be discussed with and signed by a healthcare provider. This form helps first responders know what treatments you would like in an emergency (outside of a hospital). It is especially important when you have had conversations with your healthcare team about different life-prolonging treatment options for your health and care today. Download and bring the POLST MINNESOTA form to your next medical appointment. Your healthcare provider will need to sign this form and make sure that it gets included in your electronic medical record.\", \"slug\": \"s10-mn-polst\", \"source_url\": \"https://www.health.mn.gov/people/palliative/advcareplan.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Minnesota Legislature, Office of the Revisor of Statutes\", \"quote\": \"I am not named as a health care agent or alternate health care agent in this document.​ ................................................................................... (Signature of Notary)​ (Notary Stamp)​ Option 2: Two Witnesses​ Two witnesses must sign. Only one of the two witnesses can be a health care provider or an employee​ of a health care provider giving direct care to me on the day I sign this document.​ Witness One:​ (i) In my presence on ............... (date), ............... (name) acknowledged his/her signature on this document​ or acknowledged that he/she authorized the person signing this document to sign on his/her behalf.​ (ii) I am at least 18 years of age.​ (iii) I am not named as a health care agent or an alternate health care agent in this document.​\", \"slug\": \"s10-mn-witness-scope\", \"source_url\": \"https://www.revisor.mn.gov/statutes/cite/145C.16/pdf\"}]", "source_urls": "https://www.health.mn.gov/people/palliative/advcareplan.html; https://www.revisor.mn.gov/statutes/cite/145C.16/pdf; https://www.revisor.mn.gov/statutes/cite/523/full", "state": "Minnesota" }, { "advance": "Not published", "advance_url": "https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf", "checked_on": "2026-10-22", "code": "MS", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf\"}, \"execution\": {\"facts\": [], \"quote\": true, \"text\": \"Not published\", \"url\": \"https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.legislature.ms.gov/\"}, \"polst\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf\"}}, \"facts\": [\"s10-ms-official-context\"], \"id\": \"ms\", \"notes\": [{\"facts\": [\"s10-ms-official-context\"], \"text\": \"The health department hospice standards describe treatment instructions and designation of a decision maker. This source is context for a lawyer discussion.\"}], \"office_url\": \"https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf\", \"state\": \"Mississippi\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The health department hospice standards describe treatment instructions and designation of a decision maker. This source is context for a lawyer discussion.", "execution": "Not published", "execution_url": "https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf", "fact_slugs": "s10-ms-official-context", "financial": "Not published", "financial_url": "https://www.legislature.ms.gov/", "next_check_on": "2027-01-22", "office_url": "https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf", "polst": "Not published", "polst_url": "https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf", "publishers": "Mississippi State Department of Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Mississippi State Department of Health\", \"quote\": \"Advance Directives – Directive from the patient/family (see definition of family) such as a durable power of attorney for health care, a directive pursuant to patient self-determination initiatives, a living will, or an oral directive which either states a person’s choices for medical treatment or, in the event the person is unable to make treatment choices, designates who shall make those decisions.\", \"slug\": \"s10-ms-official-context\", \"source_url\": \"https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf\"}]", "source_urls": "https://msdh.ms.gov/msdhsite/index.cfm/30%2C2348%2C83%2C60%2Cpdf/Hospice_regulations.pdf", "state": "Mississippi" }, { "advance": "Sample declaration concerning death-prolonging procedures. RSMo 459.015", "advance_url": "https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015", "checked_on": "2026-10-22", "code": "MO", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-mo-advance\"], \"text\": \"Sample declaration concerning death-prolonging procedures. RSMo 459.015\", \"url\": \"https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015\"}, \"execution\": {\"facts\": [\"s10-mo-execution\"], \"quote\": true, \"text\": \"The declaration made pursuant to sections 459.010 to 459.055 shall be: (1) In writing; (2) Signed by the person making the declaration, or by another person in the declarant's presence and by the declarant's expressed direction; (3) Dated; and (4) If not wholly in the declarant's handwriting, signed in the presence of two or more witnesses at least eighteen years of age neither of whom shall be the person who signed the declaration on behalf of and at the direction of the person making the declaration.\", \"url\": \"https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://revisor.mo.gov/main/OneSection.aspx?section=404.705\"}, \"polst\": {\"facts\": [\"s10-mo-polst\"], \"text\": \"Transportable Physician Orders for Patient Preferences (TPOPP) and POLST. Statutory recognition\", \"url\": \"https://revisor.mo.gov/main/OneSection.aspx?section=190.613\"}}, \"facts\": [\"s10-mo-advance\", \"s10-mo-execution\", \"s10-mo-polst\"], \"id\": \"mo\", \"notes\": [{\"facts\": [\"s10-mo-advance\", \"s10-mo-execution\"], \"text\": \"The linked form is the statutory treatment declaration. The statute makes witnesses conditional on whether the declaration is wholly handwritten.\"}, {\"facts\": [\"s10-mo-polst\"], \"text\": \"The cited TPOPP and POLST provision requires department review and approval. The linked statute contains its additional conditions.\"}], \"office_url\": \"https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015\", \"state\": \"Missouri\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The linked form is the statutory treatment declaration. The statute makes witnesses conditional on whether the declaration is wholly handwritten. The cited TPOPP and POLST provision requires department review and approval. The linked statute contains its additional conditions.", "execution": "The declaration made pursuant to sections 459.010 to 459.055 shall be: (1) In writing; (2) Signed by the person making the declaration, or by another person in the declarant's presence and by the declarant's expressed direction; (3) Dated; and (4) If not wholly in the declarant's handwriting, signed in the presence of two or more witnesses at least eighteen years of age neither of whom shall be the person who signed the declaration on behalf of and at the direction of the person making the declaration.", "execution_url": "https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015", "fact_slugs": "s10-mo-advance; s10-mo-execution; s10-mo-polst", "financial": "Not published", "financial_url": "https://revisor.mo.gov/main/OneSection.aspx?section=404.705", "next_check_on": "2027-01-22", "office_url": "https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015", "polst": "Transportable Physician Orders for Patient Preferences (TPOPP) and POLST. Statutory recognition", "polst_url": "https://revisor.mo.gov/main/OneSection.aspx?section=190.613", "publishers": "Missouri Revisor of Statutes", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Missouri Revisor of Statutes\", \"quote\": \"The declaration may be in the following form, but it shall not be necessary to use this sample form. In addition, the declaration may include other specific directions. Should any of the other specific directions be held to be invalid, such invalidity shall not affect other directions of the declaration which can be given effect without the invalid declaration, and to this end the directions in the declaration are severable.\", \"slug\": \"s10-mo-advance\", \"source_url\": \"https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Missouri Revisor of Statutes\", \"quote\": \"The declaration made pursuant to sections 459.010 to 459.055 shall be: (1) In writing; (2) Signed by the person making the declaration, or by another person in the declarant's presence and by the declarant's expressed direction; (3) Dated; and (4) If not wholly in the declarant's handwriting, signed in the presence of two or more witnesses at least eighteen years of age neither of whom shall be the person who signed the declaration on behalf of and at the direction of the person making the declaration.\", \"slug\": \"s10-mo-execution\", \"source_url\": \"https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Missouri Revisor of Statutes\", \"quote\": \"Transportable Physician Orders for Patient Preferences (TPOPP)/Physician Orders for Life-Sustaining Treatment (POLST) form containing a specific do-not-resuscitate section. Have been previously reviewed and approved by the department as in compliance with the provisions of sections 190.600 to 190.621\", \"slug\": \"s10-mo-polst\", \"source_url\": \"https://revisor.mo.gov/main/OneSection.aspx?section=190.613\"}]", "source_urls": "https://revisor.mo.gov/main/OneSection.aspx?section=190.613; https://www.revisor.mo.gov/main/OneSection.aspx?bid=25812&hl=+to+459.%25u2044459.015&hlr=y§ion=459.015", "state": "Missouri" }, { "advance": "My Choices Advance Directive", "advance_url": "https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf", "checked_on": "2026-10-22", "code": "MT", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-mt-advance\"], \"text\": \"My Choices Advance Directive\", \"url\": \"https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf\"}, \"execution\": {\"facts\": [\"s10-mt-execution\"], \"quote\": true, \"text\": \"Ask two people to watch you sign and have them sign below. If you can, it’s best to sign this document in front of a Notary Public.\", \"url\": \"https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf\"}, \"financial\": {\"facts\": [\"s10-mt-financial\"], \"text\": \"Statutory Form Power of Attorney. MCA 72-31-353\", \"url\": \"https://courts.mt.gov/Forms/guardianship\"}, \"polst\": {\"facts\": [\"s10-mt-polst\"], \"text\": \"Provider Orders for Life-Sustaining Treatment (POLST)\", \"url\": \"https://dphhs.mt.gov/publichealth/emsts/polst\"}}, \"facts\": [\"s10-mt-advance\", \"s10-mt-execution\", \"s10-mt-financial\", \"s10-mt-polst\", \"s10-mt-witness-scope\"], \"id\": \"mt\", \"notes\": [{\"facts\": [\"s10-mt-witness-scope\", \"s10-mt-execution\"], \"text\": \"The form asks two witnesses to sign. Its witnesses attest they are over eighteen and observed voluntary signing. The form recommends notarization.\"}], \"office_url\": \"https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf\", \"state\": \"Montana\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The form asks two witnesses to sign. Its witnesses attest they are over eighteen and observed voluntary signing. The form recommends notarization.", "execution": "Ask two people to watch you sign and have them sign below. If you can, it’s best to sign this document in front of a Notary Public.", "execution_url": "https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf", "fact_slugs": "s10-mt-advance; s10-mt-execution; s10-mt-financial; s10-mt-polst; s10-mt-witness-scope", "financial": "Statutory Form Power of Attorney. MCA 72-31-353", "financial_url": "https://courts.mt.gov/Forms/guardianship", "next_check_on": "2027-01-22", "office_url": "https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf", "polst": "Provider Orders for Life-Sustaining Treatment (POLST)", "polst_url": "https://dphhs.mt.gov/publichealth/emsts/polst", "publishers": "Montana Department of Justice; Montana Department of Public Health and Human Services; Montana Judicial Branch", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Montana Department of Justice\", \"quote\": \"Montana Department of Justice Office of Consumer Protection MONTANA END-OF-LIFE REGISTRY https://dojmt.gov/consumer/end-of-life-registry/ My Choices Advance Directive\", \"slug\": \"s10-mt-advance\", \"source_url\": \"https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Montana Department of Justice\", \"quote\": \"Ask two people to watch you sign and have them sign below. If you can, it’s best to sign this document in front of a Notary Public.\", \"slug\": \"s10-mt-execution\", \"source_url\": \"https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Montana Judicial Branch\", \"quote\": \"Statutory Form Power of Attorney, MCA 72-31-353\", \"slug\": \"s10-mt-financial\", \"source_url\": \"https://courts.mt.gov/Forms/guardianship\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Montana Department of Public Health and Human Services\", \"quote\": \"POLST: Provider Orders for Life-Sustaining Treatment\", \"slug\": \"s10-mt-polst\", \"source_url\": \"https://dphhs.mt.gov/publichealth/emsts/polst\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Montana Department of Justice\", \"quote\": \"I declare that I am over the age of 18 and the person who signed this document has signed these health care advance directives in my presence, and appears to be of sound mind and under no duress, fraud or undue influence.\", \"slug\": \"s10-mt-witness-scope\", \"source_url\": \"https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf\"}]", "source_urls": "https://courts.mt.gov/Forms/guardianship; https://dojmt.gov/wp-content/uploads/My-Choices-Advance-Directive-8.28.17.pdf; https://dphhs.mt.gov/publichealth/emsts/polst", "state": "Montana" }, { "advance": "Statutory Power of Attorney for Health Care. Nebraska Revised Statutes 30-3408", "advance_url": "https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432", "checked_on": "2026-10-22", "code": "NE", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ne-advance\"], \"text\": \"Statutory Power of Attorney for Health Care. Nebraska Revised Statutes 30-3408\", \"url\": \"https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432\"}, \"execution\": {\"facts\": [\"s10-ne-execution\"], \"quote\": true, \"text\": \"The power of attorney for health care shall (1) be in writing, (2) identify the principal, the attorney in fact, and the successor attorney in fact, if any, (3) specifically authorize the attorney in fact to make health care decisions on behalf of the principal in the event the principal is incapable, (4) show the date of its execution, and (5) be witnessed and signed by at least two adults, each of whom witnesses either the signing and dating of the power of attorney for health care by the principal or the principal's acknowledgment of the signature and date, or be signed and acknowledged by the principal before a notary public who shall not be the attorney in fact or successor attorney in fact.\", \"url\": \"https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432\"}, \"financial\": {\"facts\": [\"s10-ne-financial\"], \"text\": \"Statutory Power of Attorney form and instructions\", \"url\": \"https://supremecourt.nebraska.gov/self-help/medical/power-attorney\"}, \"polst\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432\"}}, \"facts\": [\"s10-ne-advance\", \"s10-ne-execution\", \"s10-ne-financial\", \"s10-ne-witness-scope\"], \"id\": \"ne\", \"notes\": [{\"facts\": [\"s10-ne-witness-scope\"], \"text\": \"The statute lists disqualified witnesses, including specified relatives, estate beneficiaries, certain care professionals, a romantic partner, and the attorney in fact. It also limits provider employees to one witness.\"}], \"office_url\": \"https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432\", \"state\": \"Nebraska\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The statute lists disqualified witnesses, including specified relatives, estate beneficiaries, certain care professionals, a romantic partner, and the attorney in fact. It also limits provider employees to one witness.", "execution": "The power of attorney for health care shall (1) be in writing, (2) identify the principal, the attorney in fact, and the successor attorney in fact, if any, (3) specifically authorize the attorney in fact to make health care decisions on behalf of the principal in the event the principal is incapable, (4) show the date of its execution, and (5) be witnessed and signed by at least two adults, each of whom witnesses either the signing and dating of the power of attorney for health care by the principal or the principal's acknowledgment of the signature and date, or be signed and acknowledged by the principal before a notary public who shall not be the attorney in fact or successor attorney in fact.", "execution_url": "https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432", "fact_slugs": "s10-ne-advance; s10-ne-execution; s10-ne-financial; s10-ne-witness-scope", "financial": "Statutory Power of Attorney form and instructions", "financial_url": "https://supremecourt.nebraska.gov/self-help/medical/power-attorney", "next_check_on": "2027-01-22", "office_url": "https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432", "polst": "Not published", "polst_url": "https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432", "publishers": "Nebraska Judicial Branch; Nebraska Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nebraska Legislature\", \"quote\": \"A power of attorney for health care executed on or after September 9, 1993, shall be in a form which complies with sections 30-3401 to 30-3432 and may be in the form provided in this subsection.\", \"slug\": \"s10-ne-advance\", \"source_url\": \"https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nebraska Legislature\", \"quote\": \"The power of attorney for health care shall (1) be in writing, (2) identify the principal, the attorney in fact, and the successor attorney in fact, if any, (3) specifically authorize the attorney in fact to make health care decisions on behalf of the principal in the event the principal is incapable, (4) show the date of its execution, and (5) be witnessed and signed by at least two adults, each of whom witnesses either the signing and dating of the power of attorney for health care by the principal or the principal's acknowledgment of the signature and date, or be signed and acknowledged by the principal before a notary public who shall not be the attorney in fact or successor attorney in fact.\", \"slug\": \"s10-ne-execution\", \"source_url\": \"https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nebraska Judicial Branch\", \"quote\": \"Facts about the Statutory Power of Attorney Form in Nebraska (DC 6:12) Important Information This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (you are the “principal”). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself.\", \"slug\": \"s10-ne-financial\", \"source_url\": \"https://supremecourt.nebraska.gov/self-help/medical/power-attorney\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nebraska Legislature\", \"quote\": \"The following shall not qualify to witness a power of attorney for health care: Any person who at the time of witnessing is the principal's spouse, parent, child, grandchild, sibling, presumptive heir, known devisee, attending physician, mental health treatment team member, romantic or dating partner, or attorney in fact; or an employee of a life or health insurance provider for the principal. (b) No more than one witness may be an administrator or employee of a health care provider who is caring for or treating the principal.\", \"slug\": \"s10-ne-witness-scope\", \"source_url\": \"https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432\"}]", "source_urls": "https://nebraskalegislature.gov/laws/display_html.php?begin_section=30-3401&end_section=30-3432; https://supremecourt.nebraska.gov/self-help/medical/power-attorney", "state": "Nebraska" }, { "advance": "Statutory Advance Health-Care Directive. NRS 162A.855", "advance_url": "https://www.leg.state.nv.us/nrs/nrs-162a.html", "checked_on": "2026-10-22", "code": "NV", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-nv-advance\"], \"text\": \"Statutory Advance Health-Care Directive. NRS 162A.855\", \"url\": \"https://www.leg.state.nv.us/nrs/nrs-162a.html\"}, \"execution\": {\"facts\": [\"s10-nv-execution\"], \"quote\": true, \"text\": \"A power of attorney for health care must be signed by the principal. The principal’s signature on the power of attorney for health care must be: (a) Acknowledged before a notary public; or (b) Witnessed by two adult witnesses. 3. Neither of the witnesses to a principal’s signature may be the owner, operator or employee of a nursing home if the principal resides in the nursing home.\", \"url\": \"https://www.leg.state.nv.us/nrs/nrs-162a.html\"}, \"financial\": {\"facts\": [\"s10-nv-financial\"], \"text\": \"Statutory Form Power of Attorney. NRS 162A.620\", \"url\": \"https://www.leg.state.nv.us/nrs/nrs-162a.html\"}, \"polst\": {\"facts\": [\"s10-nv-polst\"], \"text\": \"Physician Order for Life-Sustaining Treatment (POLST)\", \"url\": \"https://www.dpbh.nv.gov/regulatory/emergency-medical-systems-ems/do-not-resuscitate-dnr-physician-order-for-life-sustaining-treatment-polst/\"}}, \"facts\": [\"s10-nv-advance\", \"s10-nv-execution\", \"s10-nv-financial\", \"s10-nv-polst\"], \"id\": \"nv\", \"notes\": [], \"office_url\": \"https://www.leg.state.nv.us/nrs/nrs-162a.html\", \"state\": \"Nevada\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "A power of attorney for health care must be signed by the principal. The principal’s signature on the power of attorney for health care must be: (a) Acknowledged before a notary public; or (b) Witnessed by two adult witnesses. 3. Neither of the witnesses to a principal’s signature may be the owner, operator or employee of a nursing home if the principal resides in the nursing home.", "execution_url": "https://www.leg.state.nv.us/nrs/nrs-162a.html", "fact_slugs": "s10-nv-advance; s10-nv-execution; s10-nv-financial; s10-nv-polst", "financial": "Statutory Form Power of Attorney. NRS 162A.620", "financial_url": "https://www.leg.state.nv.us/nrs/nrs-162a.html", "next_check_on": "2027-01-22", "office_url": "https://www.leg.state.nv.us/nrs/nrs-162a.html", "polst": "Physician Order for Life-Sustaining Treatment (POLST)", "polst_url": "https://www.dpbh.nv.gov/regulatory/emergency-medical-systems-ems/do-not-resuscitate-dnr-physician-order-for-life-sustaining-treatment-polst/", "publishers": "Nevada Division of Public and Behavioral Health; Nevada Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nevada Legislature\", \"quote\": \"The following form may be used to create an advance health-care directive.\", \"slug\": \"s10-nv-advance\", \"source_url\": \"https://www.leg.state.nv.us/nrs/nrs-162a.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nevada Legislature\", \"quote\": \"A power of attorney for health care must be signed by the principal. The principal’s signature on the power of attorney for health care must be: (a) Acknowledged before a notary public; or (b) Witnessed by two adult witnesses. 3. Neither of the witnesses to a principal’s signature may be the owner, operator or employee of a nursing home if the principal resides in the nursing home.\", \"slug\": \"s10-nv-execution\", \"source_url\": \"https://www.leg.state.nv.us/nrs/nrs-162a.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nevada Legislature\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by NRS 162A.200 to 162A.660, inclusive: STATUTORY FORM POWER OF ATTORNEY THIS IS AN IMPORTANT LEGAL DOCUMENT. IT CREATES A DURABLE POWER OF ATTORNEY FOR FINANCIAL MATTERS.\", \"slug\": \"s10-nv-financial\", \"source_url\": \"https://www.leg.state.nv.us/nrs/nrs-162a.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Nevada Division of Public and Behavioral Health\", \"quote\": \"Physician Order for Life-Sustaining Treatment (POLST)\", \"slug\": \"s10-nv-polst\", \"source_url\": \"https://www.dpbh.nv.gov/regulatory/emergency-medical-systems-ems/do-not-resuscitate-dnr-physician-order-for-life-sustaining-treatment-polst/\"}]", "source_urls": "https://www.dpbh.nv.gov/regulatory/emergency-medical-systems-ems/do-not-resuscitate-dnr-physician-order-for-life-sustaining-treatment-polst/; https://www.leg.state.nv.us/nrs/nrs-162a.html", "state": "Nevada" }, { "advance": "Statutory Advance Directive. RSA 137-J section 20", "advance_url": "https://gc.nh.gov/rsa/html/x/137-J/137-J-20.htm", "checked_on": "2026-10-22", "code": "NH", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-nh-advance\"], \"text\": \"Statutory Advance Directive. RSA 137-J section 20\", \"url\": \"https://gc.nh.gov/rsa/html/x/137-J/137-J-20.htm\"}, \"execution\": {\"facts\": [\"s10-nh-execution\"], \"quote\": true, \"text\": \"You must sign this form in the physical presence of 2 witnesses or a notary or justice of the peace for it to be valid. The witnesses cannot be your agent, spouse, heir, or anyone named in your will, trust or who may otherwise receive your property at your death, or your attending medical practitioner or anyone who works directly under them. Only one witness can be employed by your health or residential care provider.\", \"url\": \"https://gc.nh.gov/rsa/html/X/137-J/137-J-19.htm\"}, \"financial\": {\"facts\": [\"s10-nh-financial\"], \"text\": \"Statutory Power of Attorney. RSA 564-E section 301\", \"url\": \"https://gc.nh.gov/rsa/html/LVI/564-E/564-E-301.htm\"}, \"polst\": {\"facts\": [\"s10-nh-polst\"], \"text\": \"Provider Orders for Life-Sustaining Treatment (POLST)\", \"url\": \"https://gc.nh.gov/rsa/html/X/137-L/137-L-mrg.htm\"}}, \"facts\": [\"s10-nh-advance\", \"s10-nh-execution\", \"s10-nh-financial\", \"s10-nh-polst\"], \"id\": \"nh\", \"notes\": [], \"office_url\": \"https://gc.nh.gov/rsa/html/x/137-J/137-J-20.htm\", \"state\": \"New Hampshire\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "You must sign this form in the physical presence of 2 witnesses or a notary or justice of the peace for it to be valid. The witnesses cannot be your agent, spouse, heir, or anyone named in your will, trust or who may otherwise receive your property at your death, or your attending medical practitioner or anyone who works directly under them. Only one witness can be employed by your health or residential care provider.", "execution_url": "https://gc.nh.gov/rsa/html/X/137-J/137-J-19.htm", "fact_slugs": "s10-nh-advance; s10-nh-execution; s10-nh-financial; s10-nh-polst", "financial": "Statutory Power of Attorney. RSA 564-E section 301", "financial_url": "https://gc.nh.gov/rsa/html/LVI/564-E/564-E-301.htm", "next_check_on": "2027-01-22", "office_url": "https://gc.nh.gov/rsa/html/x/137-J/137-J-20.htm", "polst": "Provider Orders for Life-Sustaining Treatment (POLST)", "polst_url": "https://gc.nh.gov/rsa/html/X/137-L/137-L-mrg.htm", "publishers": "New Hampshire General Court", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Hampshire General Court\", \"quote\": \"An advance directive in its individual \\\"Durable Power of Attorney for Health Care\\\" and \\\"Living Will\\\" components shall be in substantially the following form:\", \"slug\": \"s10-nh-advance\", \"source_url\": \"https://gc.nh.gov/rsa/html/x/137-J/137-J-20.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Hampshire General Court\", \"quote\": \"You must sign this form in the physical presence of 2 witnesses or a notary or justice of the peace for it to be valid. The witnesses cannot be your agent, spouse, heir, or anyone named in your will, trust or who may otherwise receive your property at your death, or your attending medical practitioner or anyone who works directly under them. Only one witness can be employed by your health or residential care provider.\", \"slug\": \"s10-nh-execution\", \"source_url\": \"https://gc.nh.gov/rsa/html/X/137-J/137-J-19.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Hampshire General Court\", \"quote\": \"A document substantially in the following form may be used to create a power of attorney that is in compliance with the provisions of this chapter. NEW HAMPSHIRE STATUTORY POWER OF ATTORNEY\", \"slug\": \"s10-nh-financial\", \"source_url\": \"https://gc.nh.gov/rsa/html/LVI/564-E/564-E-301.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Hampshire General Court\", \"quote\": \"\\\"POLST\\\" means a provider order for life-sustaining treatment signed by a physician, advanced practice registered nurse, or physician associate.\", \"slug\": \"s10-nh-polst\", \"source_url\": \"https://gc.nh.gov/rsa/html/X/137-L/137-L-mrg.htm\"}]", "source_urls": "https://gc.nh.gov/rsa/html/LVI/564-E/564-E-301.htm; https://gc.nh.gov/rsa/html/X/137-J/137-J-19.htm; https://gc.nh.gov/rsa/html/X/137-L/137-L-mrg.htm; https://gc.nh.gov/rsa/html/x/137-J/137-J-20.htm", "state": "New Hampshire" }, { "advance": "Proxy Directive form", "advance_url": "https://www.nj.gov/health/advancedirective/documents/proxy_directive.pdf", "checked_on": "2026-10-22", "code": "NJ", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-nj-advance\"], \"text\": \"Proxy Directive form\", \"url\": \"https://www.nj.gov/health/advancedirective/documents/proxy_directive.pdf\"}, \"execution\": {\"facts\": [\"s10-nj-execution\"], \"quote\": true, \"text\": \"You can choose to get your advance directive notarized, in which case you don't need additional witnesses. Or you can choose to sign and date your advance directive in front of two adult witnesses who must also sign and date the document.\", \"url\": \"https://www.nj.gov/health/advancedirective/ad/forums-faqs/index.shtml\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://surrogate.bergencountynj.gov/poa.html\"}, \"polst\": {\"facts\": [\"s10-nj-polst\"], \"text\": \"Practitioner Orders for Life-Sustaining Treatment (POLST)\", \"url\": \"https://www.nj.gov/health/advancedirective/polst/\"}}, \"facts\": [\"s10-nj-advance\", \"s10-nj-execution\", \"s10-nj-polst\", \"s10-nj-witness-scope\"], \"id\": \"nj\", \"notes\": [{\"facts\": [\"s10-nj-witness-scope\"], \"text\": \"The person appointed as health care representative cannot witness the advance directive.\"}], \"office_url\": \"https://www.nj.gov/health/advancedirective/documents/proxy_directive.pdf\", \"state\": \"New Jersey\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The person appointed as health care representative cannot witness the advance directive.", "execution": "You can choose to get your advance directive notarized, in which case you don't need additional witnesses. Or you can choose to sign and date your advance directive in front of two adult witnesses who must also sign and date the document.", "execution_url": "https://www.nj.gov/health/advancedirective/ad/forums-faqs/index.shtml", "fact_slugs": "s10-nj-advance; s10-nj-execution; s10-nj-polst; s10-nj-witness-scope", "financial": "Not published", "financial_url": "https://surrogate.bergencountynj.gov/poa.html", "next_check_on": "2027-01-22", "office_url": "https://www.nj.gov/health/advancedirective/documents/proxy_directive.pdf", "polst": "Practitioner Orders for Life-Sustaining Treatment (POLST)", "polst_url": "https://www.nj.gov/health/advancedirective/polst/", "publishers": "New Jersey Department of Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Jersey Department of Health\", \"quote\": \"PROXY DIRECTIVE\", \"slug\": \"s10-nj-advance\", \"source_url\": \"https://www.nj.gov/health/advancedirective/documents/proxy_directive.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Jersey Department of Health\", \"quote\": \"You can choose to get your advance directive notarized, in which case you don't need additional witnesses. Or you can choose to sign and date your advance directive in front of two adult witnesses who must also sign and date the document.\", \"slug\": \"s10-nj-execution\", \"source_url\": \"https://www.nj.gov/health/advancedirective/ad/forums-faqs/index.shtml\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Jersey Department of Health\", \"quote\": \"The Practitioner Orders for Life Sustaining Treatment (POLST) form enables patients to indicate their preferences regarding life-sustaining treatment. This form, signed by a patient's attending physician, advanced practice nurse or physician’s assistant, provides instructions for health care personnel to follow for a range of life-prolonging interventions. This form becomes part of a patient's medical records, following the patient from one healthcare setting to another, including hospital, nursing home or hospice.\", \"slug\": \"s10-nj-polst\", \"source_url\": \"https://www.nj.gov/health/advancedirective/polst/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Jersey Department of Health\", \"quote\": \"the person who you appoint as your healthcare representative cannot be a witness.\", \"slug\": \"s10-nj-witness-scope\", \"source_url\": \"https://www.nj.gov/health/advancedirective/ad/forums-faqs/index.shtml\"}]", "source_urls": "https://www.nj.gov/health/advancedirective/ad/forums-faqs/index.shtml; https://www.nj.gov/health/advancedirective/documents/proxy_directive.pdf; https://www.nj.gov/health/advancedirective/polst/", "state": "New Jersey" }, { "advance": "Not published", "advance_url": "https://www.nmhealth.org/about/erd/emsb/advd/", "checked_on": "2026-10-22", "code": "NM", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.nmhealth.org/about/erd/emsb/advd/\"}, \"execution\": {\"facts\": [], \"quote\": true, \"text\": \"Not published\", \"url\": \"https://www.nmhealth.org/about/erd/emsb/advd/\"}, \"financial\": {\"facts\": [\"s10-nm-financial\"], \"text\": \"Statutory Form Power of Attorney. NMSA 45-5B-301\", \"url\": \"https://supremecourt.nmcourts.gov/wp-content/uploads/sites/30/2024/01/Statutory-Power-of-Attorney-45-5B-301.pdf\"}, \"polst\": {\"facts\": [\"s10-nm-polst\"], \"text\": \"Medical Orders for Scope of Treatment (MOST). Health department program referral\", \"url\": \"https://www.nmhealth.org/about/erd/emsb/advd/\"}}, \"facts\": [\"s10-nm-financial\", \"s10-nm-polst\"], \"id\": \"nm\", \"notes\": [], \"office_url\": \"https://www.nmhealth.org/about/erd/emsb/advd/\", \"state\": \"New Mexico\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Not published", "execution_url": "https://www.nmhealth.org/about/erd/emsb/advd/", "fact_slugs": "s10-nm-financial; s10-nm-polst", "financial": "Statutory Form Power of Attorney. NMSA 45-5B-301", "financial_url": "https://supremecourt.nmcourts.gov/wp-content/uploads/sites/30/2024/01/Statutory-Power-of-Attorney-45-5B-301.pdf", "next_check_on": "2027-01-22", "office_url": "https://www.nmhealth.org/about/erd/emsb/advd/", "polst": "Medical Orders for Scope of Treatment (MOST). Health department program referral", "polst_url": "https://www.nmhealth.org/about/erd/emsb/advd/", "publishers": "New Mexico Department of Health; New Mexico Supreme Court", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Mexico Supreme Court\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by the Uniform Power of Attorney Act: \\\"NEW MEXICO STATUTORY FORM POWER OF ATTORNEY IMPORTANT INFORMATION” This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself. The meaning of authority over subjects listed on this form is explained in the Uniform Power of Attorney Act. This power of attorney does not authorize the agent to make health care decisions for you.\", \"slug\": \"s10-nm-financial\", \"source_url\": \"https://supremecourt.nmcourts.gov/wp-content/uploads/sites/30/2024/01/Statutory-Power-of-Attorney-45-5B-301.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New Mexico Department of Health\", \"quote\": \"Medical Orders for Scope of Treatment ( MOST ) A MOST can be provided by a physician to outline a plan of care respecting the patient’s wishes concerning care at life’s end.\", \"slug\": \"s10-nm-polst\", \"source_url\": \"https://www.nmhealth.org/about/erd/emsb/advd/\"}]", "source_urls": "https://supremecourt.nmcourts.gov/wp-content/uploads/sites/30/2024/01/Statutory-Power-of-Attorney-45-5B-301.pdf; https://www.nmhealth.org/about/erd/emsb/advd/", "state": "New Mexico" }, { "advance": "Health Care Proxy form and instructions", "advance_url": "https://ag.ny.gov/publications/advance-directives", "checked_on": "2026-10-22", "code": "NY", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ny-advance\"], \"text\": \"Health Care Proxy form and instructions\", \"url\": \"https://ag.ny.gov/publications/advance-directives\"}, \"execution\": {\"facts\": [\"s10-ny-execution\"], \"quote\": true, \"text\": \"Two witnesses must watch you sign your health care proxy form and say that you appeared to sign willingly. Neither your agent nor your alternate agent can serve as a witness. You do not need to have the form notarized.\", \"url\": \"https://ag.ny.gov/publications/advance-directives\"}, \"financial\": {\"facts\": [\"s10-ny-financial\"], \"text\": \"Statutory Short Form Power of Attorney. General Obligations Law 5-1513\", \"url\": \"https://www.nysenate.gov/legislation/laws/GOB/5-1513\"}, \"polst\": {\"facts\": [\"s10-ny-polst\"], \"text\": \"Medical Orders for Life-Sustaining Treatment (MOLST)\", \"url\": \"https://healthweb-back.health.ny.gov/professionals/patients/patient_rights/molst/index.htm\"}}, \"facts\": [\"s10-ny-advance\", \"s10-ny-execution\", \"s10-ny-financial\", \"s10-ny-polst\"], \"id\": \"ny\", \"notes\": [], \"office_url\": \"https://ag.ny.gov/publications/advance-directives\", \"state\": \"New York\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Two witnesses must watch you sign your health care proxy form and say that you appeared to sign willingly. Neither your agent nor your alternate agent can serve as a witness. You do not need to have the form notarized.", "execution_url": "https://ag.ny.gov/publications/advance-directives", "fact_slugs": "s10-ny-advance; s10-ny-execution; s10-ny-financial; s10-ny-polst", "financial": "Statutory Short Form Power of Attorney. General Obligations Law 5-1513", "financial_url": "https://www.nysenate.gov/legislation/laws/GOB/5-1513", "next_check_on": "2027-01-22", "office_url": "https://ag.ny.gov/publications/advance-directives", "polst": "Medical Orders for Life-Sustaining Treatment (MOLST)", "polst_url": "https://healthweb-back.health.ny.gov/professionals/patients/patient_rights/molst/index.htm", "publishers": "New York State Department of Health; New York State Office of the Attorney General; New York State Senate", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New York State Office of the Attorney General\", \"quote\": \"The standard health care proxy form approved under New York law has sections that must be completed for your proxy to be valid.\", \"slug\": \"s10-ny-advance\", \"source_url\": \"https://ag.ny.gov/publications/advance-directives\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New York State Office of the Attorney General\", \"quote\": \"Two witnesses must watch you sign your health care proxy form and say that you appeared to sign willingly. Neither your agent nor your alternate agent can serve as a witness. You do not need to have the form notarized.\", \"slug\": \"s10-ny-execution\", \"source_url\": \"https://ag.ny.gov/publications/advance-directives\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New York State Senate\", \"quote\": \"The use of the following form, or one which substantially conforms to the following form, in the creation of a power of attorney is lawful, and, when used, and executed in accordance with subdivision one of section 5-1501B of this title, it shall be construed as a statutory short form power of attorney in accordance with the provisions of this title; provided however, that any section indicated as \\\"Optional\\\" which is not used may be omitted and replaced by the words \\\"Intentionally Omitted\\\":\", \"slug\": \"s10-ny-financial\", \"source_url\": \"https://www.nysenate.gov/legislation/laws/GOB/5-1513\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"New York State Department of Health\", \"quote\": \"Medical Orders for Life-Sustaining Treatment (MOLST)\", \"slug\": \"s10-ny-polst\", \"source_url\": \"https://healthweb-back.health.ny.gov/professionals/patients/patient_rights/molst/index.htm\"}]", "source_urls": "https://ag.ny.gov/publications/advance-directives; https://healthweb-back.health.ny.gov/professionals/patients/patient_rights/molst/index.htm; https://www.nysenate.gov/legislation/laws/GOB/5-1513", "state": "New York" }, { "advance": "Statutory Health Care Power of Attorney. G.S. 32A-25.1", "advance_url": "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html", "checked_on": "2026-10-22", "code": "NC", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-nc-advance\"], \"text\": \"Statutory Health Care Power of Attorney. G.S. 32A-25.1\", \"url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html\"}, \"execution\": {\"facts\": [\"s10-nc-execution\"], \"quote\": true, \"text\": \"Except as provided in G.S. 32A-16.1, a written instrument that substantially meets the requirements of this Article, that is signed in the presence of two qualified witnesses, and acknowledged before a notary public, pursuant to which an attorney-in-fact or agent is appointed to act for the principal in matters relating to the health care of the principal.\", \"url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html\"}, \"financial\": {\"facts\": [\"s10-nc-financial\"], \"text\": \"Statutory Form Power of Attorney. G.S. 32C-3-301\", \"url\": \"https://www3.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32C/Article_3.html\"}, \"polst\": {\"facts\": [\"s10-nc-polst\"], \"text\": \"Medical Orders for Scope of Treatment (MOST). Official program referral\", \"url\": \"https://oems.nc.gov/dnr-most/\"}}, \"facts\": [\"s10-nc-advance\", \"s10-nc-emergency-exception\", \"s10-nc-execution\", \"s10-nc-financial\", \"s10-nc-polst\", \"s10-nc-witness-scope\"], \"id\": \"nc\", \"notes\": [{\"facts\": [\"s10-nc-witness-scope\", \"s10-nc-emergency-exception\"], \"text\": \"The statute defines qualified witnesses and preserves a limited earlier emergency waiver. A lawyer should check the execution of an existing instrument.\"}, {\"facts\": [\"s10-nc-polst\"], \"text\": \"The health department limits MOST form downloads to physicians and licensed health care facilities. Use its program page to discuss MOST with a clinician.\"}], \"office_url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html\", \"state\": \"North Carolina\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The statute defines qualified witnesses and preserves a limited earlier emergency waiver. A lawyer should check the execution of an existing instrument. The health department limits MOST form downloads to physicians and licensed health care facilities. Use its program page to discuss MOST with a clinician.", "execution": "Except as provided in G.S. 32A-16.1, a written instrument that substantially meets the requirements of this Article, that is signed in the presence of two qualified witnesses, and acknowledged before a notary public, pursuant to which an attorney-in-fact or agent is appointed to act for the principal in matters relating to the health care of the principal.", "execution_url": "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html", "fact_slugs": "s10-nc-advance; s10-nc-emergency-exception; s10-nc-execution; s10-nc-financial; s10-nc-polst; s10-nc-witness-scope", "financial": "Statutory Form Power of Attorney. G.S. 32C-3-301", "financial_url": "https://www3.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32C/Article_3.html", "next_check_on": "2027-01-22", "office_url": "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html", "polst": "Medical Orders for Scope of Treatment (MOST). Official program referral", "polst_url": "https://oems.nc.gov/dnr-most/", "publishers": "North Carolina Department of Health and Human Services, Office of Emergency Medical Services; North Carolina General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Carolina General Assembly\", \"quote\": \"§ 32A-25.1. Statutory form health care power of attorney.\", \"slug\": \"s10-nc-advance\", \"source_url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Carolina General Assembly\", \"quote\": \"Health care powers of attorney executed without two qualified witnesses during the time period defined in subsection (a) of this section shall contain a short and plain statement indicating that the instrument was executed in accordance with the procedures of this section. This section shall expire at 12:01 A.M. on August 1, 2020; provided, however, all instruments made in accordance with this section and while this section is in effect shall remain effective and shall not need to be reaffirmed.\", \"slug\": \"s10-nc-emergency-exception\", \"source_url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Carolina General Assembly\", \"quote\": \"Except as provided in G.S. 32A-16.1, a written instrument that substantially meets the requirements of this Article, that is signed in the presence of two qualified witnesses, and acknowledged before a notary public, pursuant to which an attorney-in-fact or agent is appointed to act for the principal in matters relating to the health care of the principal.\", \"slug\": \"s10-nc-execution\", \"source_url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Carolina General Assembly\", \"quote\": \"As a nonexclusive method to grant a power of attorney, a document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by this Chapter: \\\"NORTH CAROLINA STATUTORY SHORT FORM POWER OF ATTORNEY NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE DEFINED IN CHAPTER 32C OF THE NORTH CAROLINA GENERAL STATUTES, WHICH EXPRESSLY PERMITS THE USE OF ANY OTHER OR DIFFERENT FORM OF POWER OF ATTORNEY DESIRED BY THE PARTIES CONCERNED. IMPORTANT INFORMATION This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself. The meaning of authority over subjects listed on this form is explained in the North Carolina Uniform Power of Attorney Act. This power of attorney does not authorize the agent to make health care decisions for you.\", \"slug\": \"s10-nc-financial\", \"source_url\": \"https://www3.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32C/Article_3.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Carolina Department of Health and Human Services, Office of Emergency Medical Services\", \"quote\": \"Pursuant to N.C. General Statute 90-21.17 , the department, through the Office of Emergency Medical Services, has adopted an official portable Do Not Resuscitate (DNR) form and Medical Order for Scope of Treatment (MOST) form for use by physicians and other licensed healthcare facilities to assist in providing information relating to a patient’s desire for resuscitation or life-prolonging measures. These forms are available only to physicians’ offices or other licensed hospital or healthcare facilities. OEMS will no longer mail these forms to authorized physicians’ offices or other licensed hospital or healthcare facilities. These forms are now available for download and printing by authorized entities only.\", \"slug\": \"s10-nc-polst\", \"source_url\": \"https://oems.nc.gov/dnr-most/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Carolina General Assembly\", \"quote\": \"Except as provided in G.S. 32A-16.1, a witness in whose presence the principal has executed the health care power of attorney, who believes the principal to be of sound mind, and who states that he or she (i) is not related within the third degree to the principal nor to the principal's spouse, (ii) does not know nor have a reasonable expectation that he or she would be entitled to any portion of the estate of the principal upon the principal's death under any existing will or codicil of the principal or under the Intestate Succession Act as it then provides, (iii) is not the attending physician or mental health treatment provider of the principal, nor a licensed health care provider who is a paid employee of the attending physician or mental health treatment provider, nor a paid employee of a health facility in which the principal is a patient, nor a paid employee of a nursing home or any adult care home in which the principal resides, and (iv) does not have a claim against any portion of the estate of the principal at the time of the principal's execution of the health care power of attorney.\", \"slug\": \"s10-nc-witness-scope\", \"source_url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html\"}]", "source_urls": "https://oems.nc.gov/dnr-most/; https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32A/Article_3.html; https://www3.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_32C/Article_3.html", "state": "North Carolina" }, { "advance": "Optional statutory health care directive form", "advance_url": "https://ndlegis.gov/prod/cencode/t23c06-5.pdf", "checked_on": "2026-10-22", "code": "ND", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-nd-advance\"], \"text\": \"Optional statutory health care directive form\", \"url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\"}, \"execution\": {\"facts\": [\"s10-nd-execution\"], \"quote\": true, \"text\": \"A health care directive must be signed by the principal and that signature must be verified by a notary public or at least two or more subscribing witnesses who are at least eighteen years of age.\", \"url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\"}, \"polst\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\"}}, \"facts\": [\"s10-nd-advance\", \"s10-nd-execution\", \"s10-nd-witness-limits\"], \"id\": \"nd\", \"notes\": [{\"facts\": [\"s10-nd-witness-limits\", \"s10-nd-execution\"], \"text\": \"The statute has care-provider restrictions and excludes specified agents, relatives, estate beneficiaries and other financial interests from serving as notaries or witnesses. Read the complete execution section.\"}], \"office_url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\", \"state\": \"North Dakota\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The statute has care-provider restrictions and excludes specified agents, relatives, estate beneficiaries and other financial interests from serving as notaries or witnesses. Read the complete execution section.", "execution": "A health care directive must be signed by the principal and that signature must be verified by a notary public or at least two or more subscribing witnesses who are at least eighteen years of age.", "execution_url": "https://ndlegis.gov/prod/cencode/t23c06-5.pdf", "fact_slugs": "s10-nd-advance; s10-nd-execution; s10-nd-witness-limits", "financial": "Not published", "financial_url": "https://ndlegis.gov/prod/cencode/t23c06-5.pdf", "next_check_on": "2027-01-22", "office_url": "https://ndlegis.gov/prod/cencode/t23c06-5.pdf", "polst": "Not published", "polst_url": "https://ndlegis.gov/prod/cencode/t23c06-5.pdf", "publishers": "North Dakota Legislative Branch", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Dakota Legislative Branch\", \"quote\": \"The following is an optional form of a health care directive\", \"slug\": \"s10-nd-advance\", \"source_url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Dakota Legislative Branch\", \"quote\": \"A health care directive must be signed by the principal and that signature must be verified by a notary public or at least two or more subscribing witnesses who are at least eighteen years of age.\", \"slug\": \"s10-nd-execution\", \"source_url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"North Dakota Legislative Branch\", \"quote\": \"The notary public or any witness may not be, at the time of execution, the agent, the principal's spouse or heir, a person related to the principal by blood, marriage, or adoption, a person entitled to any part of the estate of the principal upon the death of the principal under a will or deed in existence or by operation of law, any other person who has, at the time of execution, any claims against the estate of the principal, a person directly financially responsible for the principal's medical care, or the attending physician of the principal.\", \"slug\": \"s10-nd-witness-limits\", \"source_url\": \"https://ndlegis.gov/prod/cencode/t23c06-5.pdf\"}]", "source_urls": "https://ndlegis.gov/prod/cencode/t23c06-5.pdf", "state": "North Dakota" }, { "advance": "Not published", "advance_url": "https://codes.ohio.gov/ohio-revised-code/section-1337.12", "checked_on": "2026-10-22", "code": "OH", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://codes.ohio.gov/ohio-revised-code/section-1337.12\"}, \"execution\": {\"facts\": [\"s10-oh-execution\"], \"quote\": true, \"text\": \"If witnessed for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be witnessed by at least two individuals who are adults and who are not ineligible to be witnesses under this division. Any person who is related to the principal by blood, marriage, or adoption, any person who is designated as the attorney in fact or alternate attorney in fact in the instrument, the attending physician of the principal, and the administrator of any nursing home in which the principal is receiving care are ineligible to be witnesses. The witnessing of a durable power of attorney for health care shall involve the principal signing, or acknowledging the principal's signature, at the end of the instrument in the presence of each witness. Then, each witness shall subscribe the witness's signature after the signature of the principal and, by doing so, attest to the witness's belief that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence. If acknowledged for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be acknowledged before a notary public, who shall make the certification described in section 147.53 of the Revised Code and also shall attest that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence.\", \"url\": \"https://codes.ohio.gov/ohio-revised-code/section-1337.12\"}, \"financial\": {\"facts\": [\"s10-oh-financial\"], \"text\": \"Statutory form power of attorney under section 1337.60\", \"url\": \"https://codes.ohio.gov/ohio-revised-code/section-1337.60\"}, \"polst\": {\"facts\": [\"s10-oh-dnr\"], \"text\": \"DNR Comfort Care and DNR Comfort Care Arrest\", \"url\": \"https://odh.ohio.gov/know-our-programs/do-not-resuscitate/welcome\"}}, \"facts\": [\"s10-oh-dnr\", \"s10-oh-execution\", \"s10-oh-financial\"], \"id\": \"oh\", \"notes\": [{\"facts\": [\"s10-oh-execution\"], \"text\": \"The execution excerpt concerns the durable power of attorney for health care. Witnesses have relationship, agency, physician and nursing-home restrictions.\"}], \"office_url\": \"https://codes.ohio.gov/ohio-revised-code/section-1337.12\", \"state\": \"Ohio\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The execution excerpt concerns the durable power of attorney for health care. Witnesses have relationship, agency, physician and nursing-home restrictions.", "execution": "If witnessed for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be witnessed by at least two individuals who are adults and who are not ineligible to be witnesses under this division. Any person who is related to the principal by blood, marriage, or adoption, any person who is designated as the attorney in fact or alternate attorney in fact in the instrument, the attending physician of the principal, and the administrator of any nursing home in which the principal is receiving care are ineligible to be witnesses. The witnessing of a durable power of attorney for health care shall involve the principal signing, or acknowledging the principal's signature, at the end of the instrument in the presence of each witness. Then, each witness shall subscribe the witness's signature after the signature of the principal and, by doing so, attest to the witness's belief that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence. If acknowledged for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be acknowledged before a notary public, who shall make the certification described in section 147.53 of the Revised Code and also shall attest that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence.", "execution_url": "https://codes.ohio.gov/ohio-revised-code/section-1337.12", "fact_slugs": "s10-oh-dnr; s10-oh-execution; s10-oh-financial", "financial": "Statutory form power of attorney under section 1337.60", "financial_url": "https://codes.ohio.gov/ohio-revised-code/section-1337.60", "next_check_on": "2027-01-22", "office_url": "https://codes.ohio.gov/ohio-revised-code/section-1337.12", "polst": "DNR Comfort Care and DNR Comfort Care Arrest", "polst_url": "https://odh.ohio.gov/know-our-programs/do-not-resuscitate/welcome", "publishers": "Ohio Department of Health; Ohio Legislative Service Commission", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Ohio Department of Health\", \"quote\": \"Do-Not-Resuscitate Comfort Care (DNRCC) and Do-Not-Resuscitate Comfort Care -Arrest (DNRCC-Arrest) orders allow individuals to make their choices pertaining to CPR known to emergency services personnel, heath care facilities, and healthcare providers.\", \"slug\": \"s10-oh-dnr\", \"source_url\": \"https://odh.ohio.gov/know-our-programs/do-not-resuscitate/welcome\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Ohio Legislative Service Commission\", \"quote\": \"If witnessed for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be witnessed by at least two individuals who are adults and who are not ineligible to be witnesses under this division. Any person who is related to the principal by blood, marriage, or adoption, any person who is designated as the attorney in fact or alternate attorney in fact in the instrument, the attending physician of the principal, and the administrator of any nursing home in which the principal is receiving care are ineligible to be witnesses. The witnessing of a durable power of attorney for health care shall involve the principal signing, or acknowledging the principal's signature, at the end of the instrument in the presence of each witness. Then, each witness shall subscribe the witness's signature after the signature of the principal and, by doing so, attest to the witness's belief that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence. If acknowledged for purposes of division (A)(1)(b) of this section, a durable power of attorney for health care shall be acknowledged before a notary public, who shall make the certification described in section 147.53 of the Revised Code and also shall attest that the principal appears to be of sound mind and not under or subject to duress, fraud, or undue influence.\", \"slug\": \"s10-oh-execution\", \"source_url\": \"https://codes.ohio.gov/ohio-revised-code/section-1337.12\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Ohio Legislative Service Commission\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by sections 1337.21 to 1337.64 of the Revised Code.\", \"slug\": \"s10-oh-financial\", \"source_url\": \"https://codes.ohio.gov/ohio-revised-code/section-1337.60\"}]", "source_urls": "https://codes.ohio.gov/ohio-revised-code/section-1337.12; https://codes.ohio.gov/ohio-revised-code/section-1337.60; https://odh.ohio.gov/know-our-programs/do-not-resuscitate/welcome", "state": "Ohio" }, { "advance": "Statutory Advance Directive for Health Care", "advance_url": "https://oksenate.gov/sites/default/files/2022-05/os63.pdf", "checked_on": "2026-10-22", "code": "OK", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ok-advance\"], \"text\": \"Statutory Advance Directive for Health Care\", \"url\": \"https://oksenate.gov/sites/default/files/2022-05/os63.pdf\"}, \"execution\": {\"facts\": [\"s10-ok-execution\"], \"quote\": true, \"text\": \"The advance directive shall be signed by the declarant and witnessed by two individuals who are eighteen (18) years of age or older who are not legatees, devisees, or heirs at law.\", \"url\": \"https://oksenate.gov/sites/default/files/2022-05/os63.pdf\"}, \"financial\": {\"facts\": [\"s10-ok-financial\"], \"text\": \"Statutory financial power of attorney under section 15-1003\", \"url\": \"https://oksenate.gov/sites/default/files/2022-05/os15.pdf\"}, \"polst\": {\"facts\": [\"s10-ok-polst\"], \"text\": \"Oklahoma Physician Orders for Life-Sustaining Treatment\", \"url\": \"https://oksenate.gov/sites/default/files/2022-05/os63.pdf\"}}, \"facts\": [\"s10-ok-advance\", \"s10-ok-execution\", \"s10-ok-financial\", \"s10-ok-polst\"], \"id\": \"ok\", \"notes\": [], \"office_url\": \"https://oksenate.gov/sites/default/files/2022-05/os63.pdf\", \"state\": \"Oklahoma\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "The advance directive shall be signed by the declarant and witnessed by two individuals who are eighteen (18) years of age or older who are not legatees, devisees, or heirs at law.", "execution_url": "https://oksenate.gov/sites/default/files/2022-05/os63.pdf", "fact_slugs": "s10-ok-advance; s10-ok-execution; s10-ok-financial; s10-ok-polst", "financial": "Statutory financial power of attorney under section 15-1003", "financial_url": "https://oksenate.gov/sites/default/files/2022-05/os15.pdf", "next_check_on": "2027-01-22", "office_url": "https://oksenate.gov/sites/default/files/2022-05/os63.pdf", "polst": "Oklahoma Physician Orders for Life-Sustaining Treatment", "polst_url": "https://oksenate.gov/sites/default/files/2022-05/os63.pdf", "publishers": "Oklahoma Senate", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oklahoma Senate\", \"quote\": \"An advance directive may be in substantially the following form: Advance Directive for Health Care\", \"slug\": \"s10-ok-advance\", \"source_url\": \"https://oksenate.gov/sites/default/files/2022-05/os63.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oklahoma Senate\", \"quote\": \"The advance directive shall be signed by the declarant and witnessed by two individuals who are eighteen (18) years of age or older who are not legatees, devisees, or heirs at law.\", \"slug\": \"s10-ok-execution\", \"source_url\": \"https://oksenate.gov/sites/default/files/2022-05/os63.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oklahoma Senate\", \"quote\": \"The following statutory form of power of attorney is legally sufficient: STATUTORY POWER OF ATTORNEY\", \"slug\": \"s10-ok-financial\", \"source_url\": \"https://oksenate.gov/sites/default/files/2022-05/os15.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oklahoma Senate\", \"quote\": \"Oklahoma Physician Orders for Life- Sustaining Treatment (POLST)\", \"slug\": \"s10-ok-polst\", \"source_url\": \"https://oksenate.gov/sites/default/files/2022-05/os63.pdf\"}]", "source_urls": "https://oksenate.gov/sites/default/files/2022-05/os15.pdf; https://oksenate.gov/sites/default/files/2022-05/os63.pdf", "state": "Oklahoma" }, { "advance": "Oregon Health Authority advance directive forms", "advance_url": "https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx", "checked_on": "2026-10-22", "code": "OR", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-or-advance\"], \"text\": \"Oregon Health Authority advance directive forms\", \"url\": \"https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx\"}, \"execution\": {\"facts\": [\"s10-or-execution\"], \"quote\": true, \"text\": \"You must sign this form for it to be effective. You must also have it witnessed by two witnesses or a notary. Your appointment of a health care representative is not effective until the health care representative accepts the appointment.\", \"url\": \"https://www.oregon.gov/oha/PH/ABOUT/Documents/ADAC%20RAC/LARGE%20PRINT%20OHA%203905_OR%20Advance%20Directive%20for%20Health_v1.1.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx\"}, \"polst\": {\"facts\": [\"s10-or-polst\"], \"text\": \"Physician Orders for Life-Sustaining Treatment\", \"url\": \"https://www.oregon.gov/oha/PH/ABOUT/Pages/AdvanceDirectiveAdoptionCommittee.aspx\"}}, \"facts\": [\"s10-or-advance\", \"s10-or-execution\", \"s10-or-polst\", \"s10-or-witness-limits\"], \"id\": \"or\", \"notes\": [{\"facts\": [\"s10-or-witness-limits\"], \"text\": \"Witnesses must meet the form declaration. The representative or alternate and the attending health care provider cannot act as witnesses.\"}], \"office_url\": \"https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx\", \"state\": \"Oregon\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. Witnesses must meet the form declaration. The representative or alternate and the attending health care provider cannot act as witnesses.", "execution": "You must sign this form for it to be effective. You must also have it witnessed by two witnesses or a notary. Your appointment of a health care representative is not effective until the health care representative accepts the appointment.", "execution_url": "https://www.oregon.gov/oha/PH/ABOUT/Documents/ADAC%20RAC/LARGE%20PRINT%20OHA%203905_OR%20Advance%20Directive%20for%20Health_v1.1.pdf", "fact_slugs": "s10-or-advance; s10-or-execution; s10-or-polst; s10-or-witness-limits", "financial": "Not published", "financial_url": "https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx", "next_check_on": "2027-01-22", "office_url": "https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx", "polst": "Physician Orders for Life-Sustaining Treatment", "polst_url": "https://www.oregon.gov/oha/PH/ABOUT/Pages/AdvanceDirectiveAdoptionCommittee.aspx", "publishers": "Oregon Health Authority", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oregon Health Authority\", \"quote\": \"You can use the Advance Directive forms below, which are copied from the Senate Bill 199 (2021). You do not have to use these specific forms, but any form you use must be substantially the same.\", \"slug\": \"s10-or-advance\", \"source_url\": \"https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oregon Health Authority\", \"quote\": \"You must sign this form for it to be effective. You must also have it witnessed by two witnesses or a notary. Your appointment of a health care representative is not effective until the health care representative accepts the appointment.\", \"slug\": \"s10-or-execution\", \"source_url\": \"https://www.oregon.gov/oha/PH/ABOUT/Documents/ADAC%20RAC/LARGE%20PRINT%20OHA%203905_OR%20Advance%20Directive%20for%20Health_v1.1.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oregon Health Authority\", \"quote\": \"The Oregon POLST program is designed to assure that the medical treatment wishes expressed by the patient are honored by health care professionals as the patient moves from one health care setting to another.\", \"slug\": \"s10-or-polst\", \"source_url\": \"https://www.oregon.gov/oha/PH/ABOUT/Pages/AdvanceDirectiveAdoptionCommittee.aspx\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Oregon Health Authority\", \"quote\": \"The person completing this form is personally known to me or has provided proof of identity, has signed or acknowledged the person’s signature on the document in my presence and appears to be not under duress and to understand the purpose and effect of this form. In addition, I am not the person’s health care representative or alternative health care rep- resentative, and I am not the person’s attending health care provider.\", \"slug\": \"s10-or-witness-limits\", \"source_url\": \"https://www.oregon.gov/oha/PH/ABOUT/Documents/ADAC%20RAC/LARGE%20PRINT%20OHA%203905_OR%20Advance%20Directive%20for%20Health_v1.1.pdf\"}]", "source_urls": "https://www.oregon.gov/oha/PH/ABOUT/Documents/ADAC%20RAC/LARGE%20PRINT%20OHA%203905_OR%20Advance%20Directive%20for%20Health_v1.1.pdf; https://www.oregon.gov/oha/PH/ABOUT/Pages/AdvanceDirectiveAdoptionCommittee.aspx; https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx", "state": "Oregon" }, { "advance": "Combined living will and health care power of attorney example", "advance_url": "https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM", "checked_on": "2026-10-22", "code": "PA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-pa-advance\"], \"text\": \"Combined living will and health care power of attorney example\", \"url\": \"https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM\"}, \"execution\": {\"facts\": [\"s10-pa-execution\"], \"quote\": true, \"text\": \"A health care power of attorney must be: (1) dated and signed by the principal by signature or mark or by another individual on behalf of and at the direction of the principal if the principal is unable to sign but specifically directs another individual to sign the health care power of attorney; and (2) witnessed by two individuals, each of whom is 18 years of age or older. (c) Witnesses.-- (1) An individual who signs a health care power of attorney on behalf of and at the direction of a principal may not witness the health care power of attorney. (2) A health care provider and its agent may not sign a health care power of attorney on behalf of and at the direction of a principal if the health care provider or agent provides health care services to the principal.\", \"url\": \"https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=52&subsctn=0&ttl=20&txtType=HTM\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM\"}, \"polst\": {\"facts\": [\"s10-pa-polst\"], \"text\": \"Pennsylvania POLST forms and program guidance\", \"url\": \"https://www.pa.gov/agencies/health/healthcare-and-public-health-professionals/ems/ems-resources\"}}, \"facts\": [\"s10-pa-advance\", \"s10-pa-execution\", \"s10-pa-polst\"], \"id\": \"pa\", \"notes\": [{\"facts\": [\"s10-pa-execution\"], \"text\": \"The quoted execution rule concerns a health care power of attorney. A person signing for the principal cannot also witness it.\"}], \"office_url\": \"https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM\", \"state\": \"Pennsylvania\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The quoted execution rule concerns a health care power of attorney. A person signing for the principal cannot also witness it.", "execution": "A health care power of attorney must be: (1) dated and signed by the principal by signature or mark or by another individual on behalf of and at the direction of the principal if the principal is unable to sign but specifically directs another individual to sign the health care power of attorney; and (2) witnessed by two individuals, each of whom is 18 years of age or older. (c) Witnesses.-- (1) An individual who signs a health care power of attorney on behalf of and at the direction of a principal may not witness the health care power of attorney. (2) A health care provider and its agent may not sign a health care power of attorney on behalf of and at the direction of a principal if the health care provider or agent provides health care services to the principal.", "execution_url": "https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=52&subsctn=0&ttl=20&txtType=HTM", "fact_slugs": "s10-pa-advance; s10-pa-execution; s10-pa-polst", "financial": "Not published", "financial_url": "https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM", "next_check_on": "2027-01-22", "office_url": "https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM", "polst": "Pennsylvania POLST forms and program guidance", "polst_url": "https://www.pa.gov/agencies/health/healthcare-and-public-health-professionals/ems/ems-resources", "publishers": "Pennsylvania Department of Health; Pennsylvania General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Pennsylvania General Assembly\", \"quote\": \"The following is an example of a document that combines a living will and health care power of attorney:\", \"slug\": \"s10-pa-advance\", \"source_url\": \"https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Pennsylvania General Assembly\", \"quote\": \"A health care power of attorney must be: (1) dated and signed by the principal by signature or mark or by another individual on behalf of and at the direction of the principal if the principal is unable to sign but specifically directs another individual to sign the health care power of attorney; and (2) witnessed by two individuals, each of whom is 18 years of age or older. (c) Witnesses.-- (1) An individual who signs a health care power of attorney on behalf of and at the direction of a principal may not witness the health care power of attorney. (2) A health care provider and its agent may not sign a health care power of attorney on behalf of and at the direction of a principal if the health care provider or agent provides health care services to the principal.\", \"slug\": \"s10-pa-execution\", \"source_url\": \"https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=52&subsctn=0&ttl=20&txtType=HTM\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Pennsylvania Department of Health\", \"quote\": \"POLST is a medical order that gives patients more control over their end-of-life care. The POLST form specifies the types of medical treatment that a patient wishes to receive towards the end of life. These medical orders are signed by both a patient's physician, physician's assistant, or certified registered nurse practitioner and the patient or the patient's surrogate Completion of a POLST form is only a small step in the process of a patient's decision-making, and it is critical that this form be used as part of a POLST program that includes educational support and other aspects of planning for providers and patients.\", \"slug\": \"s10-pa-polst\", \"source_url\": \"https://www.pa.gov/agencies/health/healthcare-and-public-health-professionals/ems/ems-resources\"}]", "source_urls": "https://www.pa.gov/agencies/health/healthcare-and-public-health-professionals/ems/ems-resources; https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=52&subsctn=0&ttl=20&txtType=HTM; https://www.palegis.us/statutes/consolidated/view-statute?chpt=54&div=0&iFrame=true&sctn=71&subsctn=0&ttl=20&txtType=HTM", "state": "Pennsylvania" }, { "advance": "Statutory durable power of attorney for health care", "advance_url": "https://webserver.rilegislature.gov/Statutes/TITLE23/23-4.10/23-4.10-2.HTM", "checked_on": "2026-10-22", "code": "RI", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ri-advance\"], \"text\": \"Statutory durable power of attorney for health care\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-4.10/23-4.10-2.HTM\"}, \"execution\": {\"facts\": [\"s10-ri-execution\"], \"quote\": true, \"text\": \"THIS POWER OF ATTORNEY WILL NOT BE VALID UNLESS IT IS SIGNED BY ONE NOTARY PUBLIC OR TWO (2) QUALIFIED WITNESSES WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE.\", \"url\": \"https://health.ri.gov/forms/legal/DurablePowerOfAttorneyForHealthcare.pdf\"}, \"financial\": {\"facts\": [\"s10-ri-financial\"], \"text\": \"Statutory short form power of attorney under section 18-16-2\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE18/18-16/18-16-2.htm\"}, \"polst\": {\"facts\": [\"s10-ri-molst\"], \"text\": \"Medical Orders for Life Sustaining Treatment\", \"url\": \"https://health.ri.gov/death-and-dying/medical-orders-life-sustaining-treatment-molst\"}}, \"facts\": [\"s10-ri-advance\", \"s10-ri-execution\", \"s10-ri-financial\", \"s10-ri-molst\", \"s10-ri-witness-limits\"], \"id\": \"ri\", \"notes\": [{\"facts\": [\"s10-ri-witness-limits\"], \"text\": \"The form excludes agents, providers and specified facility staff as witnesses. At least one witness or the notary must also make the nonrelative and estate-interest declaration.\"}], \"office_url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-4.10/23-4.10-2.HTM\", \"state\": \"Rhode Island\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The form excludes agents, providers and specified facility staff as witnesses. At least one witness or the notary must also make the nonrelative and estate-interest declaration.", "execution": "THIS POWER OF ATTORNEY WILL NOT BE VALID UNLESS IT IS SIGNED BY ONE NOTARY PUBLIC OR TWO (2) QUALIFIED WITNESSES WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE.", "execution_url": "https://health.ri.gov/forms/legal/DurablePowerOfAttorneyForHealthcare.pdf", "fact_slugs": "s10-ri-advance; s10-ri-execution; s10-ri-financial; s10-ri-molst; s10-ri-witness-limits", "financial": "Statutory short form power of attorney under section 18-16-2", "financial_url": "https://webserver.rilegislature.gov/Statutes/TITLE18/18-16/18-16-2.htm", "next_check_on": "2027-01-22", "office_url": "https://webserver.rilegislature.gov/Statutes/TITLE23/23-4.10/23-4.10-2.HTM", "polst": "Medical Orders for Life Sustaining Treatment", "polst_url": "https://health.ri.gov/death-and-dying/medical-orders-life-sustaining-treatment-molst", "publishers": "Rhode Island Department of Health; Rhode Island General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Rhode Island General Assembly\", \"quote\": \"The statutory form of durable power of attorney is as follows: STATUTORY FORM DURABLE POWER OF ATTORNEY FOR HEALTH CARE\", \"slug\": \"s10-ri-advance\", \"source_url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-4.10/23-4.10-2.HTM\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Rhode Island Department of Health\", \"quote\": \"THIS POWER OF ATTORNEY WILL NOT BE VALID UNLESS IT IS SIGNED BY ONE NOTARY PUBLIC OR TWO (2) QUALIFIED WITNESSES WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE.\", \"slug\": \"s10-ri-execution\", \"source_url\": \"https://health.ri.gov/forms/legal/DurablePowerOfAttorneyForHealthcare.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Rhode Island General Assembly\", \"quote\": \"The statutory short form power of attorney is as follows: SHORT FORM POWER OF ATTORNEY WARNING TO PERSON EXECUTING THIS DOCUMENT This is an important legal document which is authorized by the general laws of this state. The powers granted by this document are broad and sweeping. They are defined in §§ 18-16-1 to 18-16-12, both inclusive, of the general laws in chapter 18-16 entitled “Rhode Island Short Form Power of Attorney Act.”\", \"slug\": \"s10-ri-financial\", \"source_url\": \"https://webserver.rilegislature.gov/Statutes/TITLE18/18-16/18-16-2.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Rhode Island Department of Health\", \"quote\": \"Medical Orders for Life Sustaining Treatment (MOLST) are instructions to follow a terminally ill patient's wishes regarding resuscitation, feeding tubes and other life-sustaining medical treatments. The MOLST form can be used to refuse or request treatments and are completely voluntary on the part of patients.\", \"slug\": \"s10-ri-molst\", \"source_url\": \"https://health.ri.gov/death-and-dying/medical-orders-life-sustaining-treatment-molst\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Rhode Island Department of Health\", \"quote\": \"This document must be witnessed by two (2) qualified adult witnesses or one (1) notary public. None of the following may be used as a witness: (1) A person you designate as your agent or alternate agent, (2) A healthcare provider, (3) An employee of a healthcare provider, (4) The operator of a community care facility, (5) An employee of an operator of a community care facility. I declare under penalty of perjury that the person who signed or acknowledged this document is personally known to me to be the principal, that the principal signed or acknowledged this durable power of attorney in my presence, that the principal appears to be of sound mind and under no duress, fraud, or undue influence, that I am not the person appointed as attorney in fact by this document, and that I am not a healthcare provider, an employee of a healthcare provider, the operator of a community care facility, nor an employee of an operator of a community care facility.Page 5 Option 1 – Two (2) Qualified Witnesses: Signature: Residence Address: Print Name: Date: Signature: Residence Address: Print Name: Date: Option 2 – One Notary Public Signature Signature: , Notary Public Print Name: Date: My commission expires on: (AT LEAST ONE OF THE ABOVE WITNESSES OR THE NOTARY PUBLIC MUST ALSO SIGN THE FOLLOWING DECLARATION.) I further declare under penalty of perjury that I am not related to the principal by blood, marriage, or adoption, and, to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law.\", \"slug\": \"s10-ri-witness-limits\", \"source_url\": \"https://health.ri.gov/forms/legal/DurablePowerOfAttorneyForHealthcare.pdf\"}]", "source_urls": "https://health.ri.gov/death-and-dying/medical-orders-life-sustaining-treatment-molst; https://health.ri.gov/forms/legal/DurablePowerOfAttorneyForHealthcare.pdf; https://webserver.rilegislature.gov/Statutes/TITLE18/18-16/18-16-2.htm; https://webserver.rilegislature.gov/Statutes/TITLE23/23-4.10/23-4.10-2.HTM", "state": "Rhode Island" }, { "advance": "Statutory health care power of attorney under section 62-5-504", "advance_url": "https://www.scstatehouse.gov/code/t62c005.php", "checked_on": "2026-10-22", "code": "SC", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-sc-advance\"], \"text\": \"Statutory health care power of attorney under section 62-5-504\", \"url\": \"https://www.scstatehouse.gov/code/t62c005.php\"}, \"execution\": {\"facts\": [\"s10-sc-execution\"], \"quote\": true, \"text\": \"be signed by at least two persons, each of whom witnessed either the signing of the health care power of attorney or the principal's acknowledgment of his signature on the health care power of attorney. Each witness must state in a declaration as set forth in Section 62-5-504 that, at the time of the execution of the health care power of attorney, to the extent the witness has knowledge, the witness is not related to the principal by blood, marriage, or adoption, either as a spouse, lineal ancestor, descendant of the parents of the principal, or spouse of any of them; not directly financially responsible for the principal's medical care; not entitled to a portion of the principal's estate upon his decease under a will of the principal then existing or as an heir by intestate succession; not a beneficiary of a life insurance policy of the principal; and not appointed as health care agent or successor health care agent in the health care power of attorney; and that no more than one witness is an employee of a health care facility in which the principal is a patient, no witness is the attending physician or an employee of the attending physician, or no witness has a claim against the principal's estate upon his decease;\", \"url\": \"https://www.scstatehouse.gov/code/t62c005.php\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.scstatehouse.gov/code/t62c005.php\"}, \"polst\": {\"facts\": [\"s10-sc-post\"], \"text\": \"Physician Orders for Scope of Treatment\", \"url\": \"https://www.scstatehouse.gov/code/t44c080.php\"}}, \"facts\": [\"s10-sc-advance\", \"s10-sc-execution\", \"s10-sc-notarial-form\", \"s10-sc-post\"], \"id\": \"sc\", \"notes\": [{\"facts\": [\"s10-sc-notarial-form\", \"s10-sc-execution\"], \"text\": \"The statutory form also contains a notarial acknowledgment. Read both the form and the complete witness declarations.\"}], \"office_url\": \"https://www.scstatehouse.gov/code/t62c005.php\", \"state\": \"South Carolina\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The statutory form also contains a notarial acknowledgment. Read both the form and the complete witness declarations.", "execution": "be signed by at least two persons, each of whom witnessed either the signing of the health care power of attorney or the principal's acknowledgment of his signature on the health care power of attorney. Each witness must state in a declaration as set forth in Section 62-5-504 that, at the time of the execution of the health care power of attorney, to the extent the witness has knowledge, the witness is not related to the principal by blood, marriage, or adoption, either as a spouse, lineal ancestor, descendant of the parents of the principal, or spouse of any of them; not directly financially responsible for the principal's medical care; not entitled to a portion of the principal's estate upon his decease under a will of the principal then existing or as an heir by intestate succession; not a beneficiary of a life insurance policy of the principal; and not appointed as health care agent or successor health care agent in the health care power of attorney; and that no more than one witness is an employee of a health care facility in which the principal is a patient, no witness is the attending physician or an employee of the attending physician, or no witness has a claim against the principal's estate upon his decease;", "execution_url": "https://www.scstatehouse.gov/code/t62c005.php", "fact_slugs": "s10-sc-advance; s10-sc-execution; s10-sc-notarial-form; s10-sc-post", "financial": "Not published", "financial_url": "https://www.scstatehouse.gov/code/t62c005.php", "next_check_on": "2027-01-22", "office_url": "https://www.scstatehouse.gov/code/t62c005.php", "polst": "Physician Orders for Scope of Treatment", "polst_url": "https://www.scstatehouse.gov/code/t44c080.php", "publishers": "South Carolina Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Carolina Legislature\", \"quote\": \"Form of health care power of attorney.\", \"slug\": \"s10-sc-advance\", \"source_url\": \"https://www.scstatehouse.gov/code/t62c005.php\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Carolina Legislature\", \"quote\": \"be signed by at least two persons, each of whom witnessed either the signing of the health care power of attorney or the principal's acknowledgment of his signature on the health care power of attorney. Each witness must state in a declaration as set forth in Section 62-5-504 that, at the time of the execution of the health care power of attorney, to the extent the witness has knowledge, the witness is not related to the principal by blood, marriage, or adoption, either as a spouse, lineal ancestor, descendant of the parents of the principal, or spouse of any of them; not directly financially responsible for the principal's medical care; not entitled to a portion of the principal's estate upon his decease under a will of the principal then existing or as an heir by intestate succession; not a beneficiary of a life insurance policy of the principal; and not appointed as health care agent or successor health care agent in the health care power of attorney; and that no more than one witness is an employee of a health care facility in which the principal is a patient, no witness is the attending physician or an employee of the attending physician, or no witness has a claim against the principal's estate upon his decease;\", \"slug\": \"s10-sc-execution\", \"source_url\": \"https://www.scstatehouse.gov/code/t62c005.php\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Carolina Legislature\", \"quote\": \"The foregoing instrument was acknowledged before me by Principal on _______________, 20 _________ Notary Public for South Carolina\", \"slug\": \"s10-sc-notarial-form\", \"source_url\": \"https://www.scstatehouse.gov/code/t62c005.php\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Carolina Legislature\", \"quote\": \"This chapter may be cited as the 'Physician Orders for Scope of Treatment (POST) Act'.\", \"slug\": \"s10-sc-post\", \"source_url\": \"https://www.scstatehouse.gov/code/t44c080.php\"}]", "source_urls": "https://www.scstatehouse.gov/code/t44c080.php; https://www.scstatehouse.gov/code/t62c005.php", "state": "South Carolina" }, { "advance": "Optional statutory living will declaration", "advance_url": "https://sdlegislature.gov/api/Statutes/34-12D-3.html", "checked_on": "2026-10-22", "code": "SD", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-sd-advance\"], \"text\": \"Optional statutory living will declaration\", \"url\": \"https://sdlegislature.gov/api/Statutes/34-12D-3.html\"}, \"execution\": {\"facts\": [\"s10-sd-execution\"], \"quote\": true, \"text\": \"The declaration must be signed by the declarant, or by another at the declarant's direction, and witnessed by two adults, or by a notary public who shall thereafter notarize the declaration.\", \"url\": \"https://sdlegislature.gov/api/Statutes/34-12D-2.html\"}, \"financial\": {\"facts\": [\"s10-sd-financial\"], \"text\": \"Statutory form power of attorney under section 59-12-41\", \"url\": \"https://sdlegislature.gov/api/Statutes/59-12-41.html\"}, \"polst\": {\"facts\": [\"s10-sd-most\"], \"text\": \"Medical Order for Scope of Treatment\", \"url\": \"https://doh.sd.gov/healthcare-professionals/advance-directives-and-medical-orders/\"}}, \"facts\": [\"s10-sd-advance\", \"s10-sd-execution\", \"s10-sd-financial\", \"s10-sd-most\"], \"id\": \"sd\", \"notes\": [], \"office_url\": \"https://sdlegislature.gov/api/Statutes/34-12D-3.html\", \"state\": \"South Dakota\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "The declaration must be signed by the declarant, or by another at the declarant's direction, and witnessed by two adults, or by a notary public who shall thereafter notarize the declaration.", "execution_url": "https://sdlegislature.gov/api/Statutes/34-12D-2.html", "fact_slugs": "s10-sd-advance; s10-sd-execution; s10-sd-financial; s10-sd-most", "financial": "Statutory form power of attorney under section 59-12-41", "financial_url": "https://sdlegislature.gov/api/Statutes/59-12-41.html", "next_check_on": "2027-01-22", "office_url": "https://sdlegislature.gov/api/Statutes/34-12D-3.html", "polst": "Medical Order for Scope of Treatment", "polst_url": "https://doh.sd.gov/healthcare-professionals/advance-directives-and-medical-orders/", "publishers": "South Dakota Department of Health; South Dakota Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Dakota Legislature\", \"quote\": \"A declaration may, but need not, be in the following form: LIVING WILL DECLARATION\", \"slug\": \"s10-sd-advance\", \"source_url\": \"https://sdlegislature.gov/api/Statutes/34-12D-3.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Dakota Legislature\", \"quote\": \"The declaration must be signed by the declarant, or by another at the declarant's direction, and witnessed by two adults, or by a notary public who shall thereafter notarize the declaration.\", \"slug\": \"s10-sd-execution\", \"source_url\": \"https://sdlegislature.gov/api/Statutes/34-12D-2.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Dakota Legislature\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by this chapter.\", \"slug\": \"s10-sd-financial\", \"source_url\": \"https://sdlegislature.gov/api/Statutes/59-12-41.html\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"South Dakota Department of Health\", \"quote\": \"Medical Order for Scope of Treatment (MOST)\", \"slug\": \"s10-sd-most\", \"source_url\": \"https://doh.sd.gov/healthcare-professionals/advance-directives-and-medical-orders/\"}]", "source_urls": "https://doh.sd.gov/healthcare-professionals/advance-directives-and-medical-orders/; https://sdlegislature.gov/api/Statutes/34-12D-2.html; https://sdlegislature.gov/api/Statutes/34-12D-3.html; https://sdlegislature.gov/api/Statutes/59-12-41.html", "state": "South Dakota" }, { "advance": "Advance Directive for Health Care", "advance_url": "https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf", "checked_on": "2026-10-22", "code": "TN", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-tn-advance\"], \"text\": \"Advance Directive for Health Care\", \"url\": \"https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf\"}, \"execution\": {\"facts\": [\"s10-tn-execution\"], \"quote\": true, \"text\": \"Your signature must either be witnessed by two competent adults (“Block A”) or by a notary public (“Block B”). Neither witness may be the person you appointed as your agent or alternate, and at least one of the witnesses must be someone who is not related to you or entitled to any part of your estate.\", \"url\": \"https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf\"}, \"polst\": {\"facts\": [\"s10-tn-post\"], \"text\": \"Physician Orders for Scope of Treatment\", \"url\": \"https://www.tn.gov/health/healthyaging\"}}, \"facts\": [\"s10-tn-advance\", \"s10-tn-execution\", \"s10-tn-post\"], \"id\": \"tn\", \"notes\": [], \"office_url\": \"https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf\", \"state\": \"Tennessee\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Your signature must either be witnessed by two competent adults (“Block A”) or by a notary public (“Block B”). Neither witness may be the person you appointed as your agent or alternate, and at least one of the witnesses must be someone who is not related to you or entitled to any part of your estate.", "execution_url": "https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf", "fact_slugs": "s10-tn-advance; s10-tn-execution; s10-tn-post", "financial": "Not published", "financial_url": "https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf", "next_check_on": "2027-01-22", "office_url": "https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf", "polst": "Physician Orders for Scope of Treatment", "polst_url": "https://www.tn.gov/health/healthyaging", "publishers": "Tennessee Department of Health", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Tennessee Department of Health\", \"quote\": \"This form replaces the old forms for durable power of attorney for health care, living will, appointment of agent, and advance care plan, and eliminates the need for any of those documents.\", \"slug\": \"s10-tn-advance\", \"source_url\": \"https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Tennessee Department of Health\", \"quote\": \"Your signature must either be witnessed by two competent adults (“Block A”) or by a notary public (“Block B”). Neither witness may be the person you appointed as your agent or alternate, and at least one of the witnesses must be someone who is not related to you or entitled to any part of your estate.\", \"slug\": \"s10-tn-execution\", \"source_url\": \"https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Tennessee Department of Health\", \"quote\": \"A Physician Orders for Scope of Treatment (POST) Form is different from an Advance Directive for Health Care. A POST form is a medical order that the healthcare provider completes and signs.\", \"slug\": \"s10-tn-post\", \"source_url\": \"https://www.tn.gov/health/healthyaging\"}]", "source_urls": "https://www.tn.gov/content/dam/tn/health/documents/Advance_Directive_for_Health_Care.pdf; https://www.tn.gov/health/healthyaging", "state": "Tennessee" }, { "advance": "Medical Power of Attorney Designation of Health Care Agent", "advance_url": "https://fhb.hhs.texas.gov/forms/advance-directives/medical-power-attorney-designation-health-care-agent-mpoa", "checked_on": "2026-10-22", "code": "TX", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-tx-advance\"], \"text\": \"Medical Power of Attorney Designation of Health Care Agent\", \"url\": \"https://fhb.hhs.texas.gov/forms/advance-directives/medical-power-attorney-designation-health-care-agent-mpoa\"}, \"execution\": {\"facts\": [\"s10-tx-execution\"], \"quote\": true, \"text\": \"You Must Date And Sign This Power Of Attorney. You May Sign It And Have Your Signature Acknowledged Before A Notary Public Or You May Sign It In The Presence Of Two Competent Adult Witnesses.)\", \"url\": \"https://fhb.hhs.texas.gov/sites/default/files/documents/medical-power-of-attorney-designation-of-health-care-agent-mpoa-english.pdf\"}, \"financial\": {\"facts\": [\"s10-tx-financial\"], \"text\": \"Statutory Durable Power of Attorney\", \"url\": \"https://fhb.hhs.texas.gov/forms/advance-directives/statutory-durable-power-attorney-sdpoa\"}, \"polst\": {\"facts\": [\"s10-tx-dnr\"], \"text\": \"Out-of-Hospital Do-Not-Resuscitate order\", \"url\": \"https://fhb.hhs.texas.gov/forms/advance-directives\"}}, \"facts\": [\"s10-tx-advance\", \"s10-tx-dnr\", \"s10-tx-execution\", \"s10-tx-financial\", \"s10-tx-witness-limits\"], \"id\": \"tx\", \"notes\": [{\"facts\": [\"s10-tx-witness-limits\"], \"text\": \"At least one witness must satisfy the form's exclusions for agency, relatives, estate interests, the attending physician and specified facility staff.\"}], \"office_url\": \"https://fhb.hhs.texas.gov/forms/advance-directives/medical-power-attorney-designation-health-care-agent-mpoa\", \"state\": \"Texas\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. At least one witness must satisfy the form's exclusions for agency, relatives, estate interests, the attending physician and specified facility staff.", "execution": "You Must Date And Sign This Power Of Attorney. You May Sign It And Have Your Signature Acknowledged Before A Notary Public Or You May Sign It In The Presence Of Two Competent Adult Witnesses.)", "execution_url": "https://fhb.hhs.texas.gov/sites/default/files/documents/medical-power-of-attorney-designation-of-health-care-agent-mpoa-english.pdf", "fact_slugs": "s10-tx-advance; s10-tx-dnr; s10-tx-execution; s10-tx-financial; s10-tx-witness-limits", "financial": "Statutory Durable Power of Attorney", "financial_url": "https://fhb.hhs.texas.gov/forms/advance-directives/statutory-durable-power-attorney-sdpoa", "next_check_on": "2027-01-22", "office_url": "https://fhb.hhs.texas.gov/forms/advance-directives/medical-power-attorney-designation-health-care-agent-mpoa", "polst": "Out-of-Hospital Do-Not-Resuscitate order", "polst_url": "https://fhb.hhs.texas.gov/forms/advance-directives", "publishers": "Texas Health and Human Services Commission", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Texas Health and Human Services Commission\", \"quote\": \"Medical Power of Attorney Designation of Health Care Agent (MPOA)\", \"slug\": \"s10-tx-advance\", \"source_url\": \"https://fhb.hhs.texas.gov/forms/advance-directives/medical-power-attorney-designation-health-care-agent-mpoa\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Texas Health and Human Services Commission\", \"quote\": \"Out-of-Hospital Do-Not-Resuscitate (OOH-DNR) Order — This form instructs emergency medical personnel and other health care professionals to forgo resuscitation attempts and to permit the patient to have a natural death with peace and dignity. This order does NOT affect the provision of other emergency care including comfort care.\", \"slug\": \"s10-tx-dnr\", \"source_url\": \"https://fhb.hhs.texas.gov/forms/advance-directives\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Texas Health and Human Services Commission\", \"quote\": \"You Must Date And Sign This Power Of Attorney. You May Sign It And Have Your Signature Acknowledged Before A Notary Public Or You May Sign It In The Presence Of Two Competent Adult Witnesses.)\", \"slug\": \"s10-tx-execution\", \"source_url\": \"https://fhb.hhs.texas.gov/sites/default/files/documents/medical-power-of-attorney-designation-of-health-care-agent-mpoa-english.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Texas Health and Human Services Commission\", \"quote\": \"This form is for designating an agent who is empowered to take certain actions regarding your property. It does not authorize anyone to make medical and other healthcare decisions for you.\", \"slug\": \"s10-tx-financial\", \"source_url\": \"https://fhb.hhs.texas.gov/forms/advance-directives/statutory-durable-power-attorney-sdpoa\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Texas Health and Human Services Commission\", \"quote\": \"The Following Persons May Not Act As One Of The Witnesses: (1) the person you have designated as your agent; (2) a person related to you by blood or marriage; (3) a person entitled to any part of your estate after your death under a will or codicil executed by you or by operation of law; (4) your attending physician; (5) an employee of your attending physician; (6) an employee of a health care facility in which you are a patient if the employee is providing direct patient care to you or is an officer, director, partner, or business office employee of the health care facility or of any parent organization of the health care facility; or (7) a person who, at the time this medical power of attorney is executed, has a claim against any part of your estate after your death.\", \"slug\": \"s10-tx-witness-limits\", \"source_url\": \"https://fhb.hhs.texas.gov/sites/default/files/documents/medical-power-of-attorney-designation-of-health-care-agent-mpoa-english.pdf\"}]", "source_urls": "https://fhb.hhs.texas.gov/forms/advance-directives; https://fhb.hhs.texas.gov/forms/advance-directives/medical-power-attorney-designation-health-care-agent-mpoa; https://fhb.hhs.texas.gov/forms/advance-directives/statutory-durable-power-attorney-sdpoa; https://fhb.hhs.texas.gov/sites/default/files/documents/medical-power-of-attorney-designation-of-health-care-agent-mpoa-english.pdf", "state": "Texas" }, { "advance": "Optional advance health care directive under section 75A-9-110", "advance_url": "https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf", "checked_on": "2026-10-22", "code": "UT", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-ut-advance\"], \"text\": \"Optional advance health care directive under section 75A-9-110\", \"url\": \"https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf\"}, \"execution\": {\"facts\": [\"s10-ut-execution\"], \"quote\": true, \"text\": \"You need a witness if you are using this form to name an Agent. The witness must be an adult and cannot be the person you are naming as Agent or the Agent's spouse or someone the Agent lives with as a couple. If you live or are receiving care in a nursing home, the witness cannot be an employee or contractor of the home or someone who owns or runs the home.\", \"url\": \"https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf\"}, \"financial\": {\"facts\": [\"s10-ut-financial\"], \"text\": \"Statutory form power of attorney under section 75A-2-301\", \"url\": \"https://le.utah.gov/xcode/Title75A/Chapter2/C75A-2-S301_2024090120240501.pdf\"}, \"polst\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf\"}}, \"facts\": [\"s10-ut-advance\", \"s10-ut-execution\", \"s10-ut-financial\", \"s10-ut-witness-presence\"], \"id\": \"ut\", \"notes\": [{\"facts\": [\"s10-ut-witness-presence\", \"s10-ut-execution\"], \"text\": \"The witness rule quoted here concerns naming an agent. The law has additional witness restrictions and specified remote-presence rules.\"}], \"office_url\": \"https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf\", \"state\": \"Utah\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The witness rule quoted here concerns naming an agent. The law has additional witness restrictions and specified remote-presence rules.", "execution": "You need a witness if you are using this form to name an Agent. The witness must be an adult and cannot be the person you are naming as Agent or the Agent's spouse or someone the Agent lives with as a couple. If you live or are receiving care in a nursing home, the witness cannot be an employee or contractor of the home or someone who owns or runs the home.", "execution_url": "https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf", "fact_slugs": "s10-ut-advance; s10-ut-execution; s10-ut-financial; s10-ut-witness-presence", "financial": "Statutory form power of attorney under section 75A-2-301", "financial_url": "https://le.utah.gov/xcode/Title75A/Chapter2/C75A-2-S301_2024090120240501.pdf", "next_check_on": "2027-01-22", "office_url": "https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf", "polst": "Not published", "polst_url": "https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf", "publishers": "Utah Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Utah Legislature\", \"quote\": \"The following form may be used to create an advance health care directive\", \"slug\": \"s10-ut-advance\", \"source_url\": \"https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Utah Legislature\", \"quote\": \"You need a witness if you are using this form to name an Agent. The witness must be an adult and cannot be the person you are naming as Agent or the Agent's spouse or someone the Agent lives with as a couple. If you live or are receiving care in a nursing home, the witness cannot be an employee or contractor of the home or someone who owns or runs the home.\", \"slug\": \"s10-ut-execution\", \"source_url\": \"https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Utah Legislature\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by this chapter.\", \"slug\": \"s10-ut-financial\", \"source_url\": \"https://le.utah.gov/xcode/Title75A/Chapter2/C75A-2-S301_2024090120240501.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Utah Legislature\", \"quote\": \"A power of attorney for health care must be in a record, signed by the individual creating the power, and signed by an adult witness who: (a) reasonably believes the act of the individual to create the power of attorney is voluntary and knowing; (b) is not: (i) the agent appointed by the individual; (ii) the agent's spouse or cohabitant; or (iii) if the individual resides or is receiving care in a nursing home or assisted living facility, the owner, operator, employee, or contractor of the nursing home or assisted living facility; and (c) is present when the individual signs the power of attorney or when the individual represents that the power of attorney reflects the individual's wishes. (5) A witness under Subsection (4) is considered present if the witness and the individual are: (a) physically present in the same location; (b) using electronic means that allow for real time audio and visual transmission and communication in real time to the same extent as if the witness and the individual were physically present in the same location; or (c) able to speak to and hear each other in real time through audio connection if: (i) the identity of the individual is personally known to the witness; or (ii) the witness is able to authenticate the identity of the individual by receiving accurate answers from the individual that enable the authentication.\", \"slug\": \"s10-ut-witness-presence\", \"source_url\": \"https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9_2026010120250507.pdf\"}]", "source_urls": "https://le.utah.gov/xcode/Title75A/Chapter2/C75A-2-S301_2024090120240501.pdf; https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9-S110_2026010120250507.pdf; https://le.utah.gov/xcode/Title75A/Chapter9/C75A-9_2026010120250507.pdf", "state": "Utah" }, { "advance": "Health department advance directive form referrals", "advance_url": "https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive", "checked_on": "2026-10-22", "code": "VT", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-vt-advance\"], \"text\": \"Health department advance directive form referrals\", \"url\": \"https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive\"}, \"execution\": {\"facts\": [\"s10-vt-execution\"], \"quote\": true, \"text\": \"The advance directive shall be dated, executed by the principal or by another individual in the principal’s presence at the principal’s express direction if the principal is physically unable to do so, and signed by two or more witnesses at least 18 years of age, who shall sign and affirm that the principal appeared to understand the nature of the document and to be free from duress or undue influence at the time the advance directive was signed.\", \"url\": \"https://legislature.vermont.gov/statutes/section/18/231/09703\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive\"}, \"polst\": {\"facts\": [\"s10-vt-colst\"], \"text\": \"DNR and Clinician Orders for Life-Sustaining Treatment\", \"url\": \"https://www.healthvermont.gov/systems/advance-directives/do-not-resuscitate-dnrclinician-orders-life-sustaining-treatment-colst\"}}, \"facts\": [\"s10-vt-advance\", \"s10-vt-colst\", \"s10-vt-execution\", \"s10-vt-witness-limits\"], \"id\": \"vt\", \"notes\": [{\"facts\": [\"s10-vt-witness-limits\", \"s10-vt-execution\"], \"text\": \"The law restricts relatives and agents as witnesses. It also has remote-witness conditions and extra explanation safeguards for nursing-home, residential-care and hospital execution.\"}], \"office_url\": \"https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive\", \"state\": \"Vermont\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The law restricts relatives and agents as witnesses. It also has remote-witness conditions and extra explanation safeguards for nursing-home, residential-care and hospital execution.", "execution": "The advance directive shall be dated, executed by the principal or by another individual in the principal’s presence at the principal’s express direction if the principal is physically unable to do so, and signed by two or more witnesses at least 18 years of age, who shall sign and affirm that the principal appeared to understand the nature of the document and to be free from duress or undue influence at the time the advance directive was signed.", "execution_url": "https://legislature.vermont.gov/statutes/section/18/231/09703", "fact_slugs": "s10-vt-advance; s10-vt-colst; s10-vt-execution; s10-vt-witness-limits", "financial": "Not published", "financial_url": "https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive", "next_check_on": "2027-01-22", "office_url": "https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive", "polst": "DNR and Clinician Orders for Life-Sustaining Treatment", "polst_url": "https://www.healthvermont.gov/systems/advance-directives/do-not-resuscitate-dnrclinician-orders-life-sustaining-treatment-colst", "publishers": "Vermont Department of Health; Vermont General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Vermont Department of Health\", \"quote\": \"Appointment of a Health Care Agent Form\\nTake the first step in advance care planning by appointing a health care agent and providing some general guidance about your health care goals. Health Care Agent Form\\nFind forms in other languages\\nAdvance Directive - Short Form\\nThe form includes five (5) sections on: • Appointment of My Health Care Agent • Health Care Goals and Spiritual Wishes • Limitations of Treatment • Organ/Tissue Donation and Burial/Disposition of Remains • Signed Declaration of Wishes If you would like to skip a section of the form, please draw a line through it but do not remove any pages. Short Form Advance Directive\", \"slug\": \"s10-vt-advance\", \"source_url\": \"https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Vermont Department of Health\", \"quote\": \"DNR/COLST orders are portable, out-of-hospital medical orders used to instruct medical providers and emergency responders about any treatment limitations for an individual.\", \"slug\": \"s10-vt-colst\", \"source_url\": \"https://www.healthvermont.gov/systems/advance-directives/do-not-resuscitate-dnrclinician-orders-life-sustaining-treatment-colst\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Vermont General Assembly\", \"quote\": \"The advance directive shall be dated, executed by the principal or by another individual in the principal’s presence at the principal’s express direction if the principal is physically unable to do so, and signed by two or more witnesses at least 18 years of age, who shall sign and affirm that the principal appeared to understand the nature of the document and to be free from duress or undue influence at the time the advance directive was signed.\", \"slug\": \"s10-vt-execution\", \"source_url\": \"https://legislature.vermont.gov/statutes/section/18/231/09703\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Vermont General Assembly\", \"quote\": \"Neither the agent appointed by the principal nor the principal’s spouse, parent, adult sibling, adult child, or adult grandchild may witness the advance directive. (d)(1) An advance directive shall not be effective if, at the time of execution, the principal is being admitted to or is a resident of a nursing home as defined in 33 V.S.A. § 7102 or a residential care facility, unless one of the following individuals explains the nature and effect of an advance directive to the principal and signs a statement affirming that the individual has provided the explanation: (A) an ombudsman; (B) a recognized member of the clergy; (C) an attorney licensed to practice in this State; (D) a Probate Division of the Superior Court designee; (E) an individual designated by a hospital pursuant to subsection 9709(d) of this title; (F) a mental health patient representative; (G) an individual who is volunteering at the nursing home or residential care facility without compensation and has received appropriate training regarding the explanation of advance directives; or (H) a clinician, provided the clinician is not employed by the nursing home or residential care facility at the time of the explanation. (2) It is the intent of this subsection to ensure that residents of nursing homes and residential care facilities are willingly and voluntarily executing advance directives. (3) The individual who explains the nature and effect of an advance directive to the principal under this subsection may be physically present in the same location as the principal at the time of the explanation or may deliver the explanation to the principal through a live, interactive, audio-video connection or by telephone. (e)(1) An advance directive shall not be effective if, at the time of execution, the principal is being admitted to or is a patient in a hospital, unless one of the following individuals explains the nature and effect of an advance directive to the principal and signs a statement affirming that the individual has provided the explanation: (A) an ombudsman; (B) a recognized member of the clergy; (C) an attorney licensed to practice in this State; (D) a Probate Division of the Superior Court designee; (E) an individual designated by the hospital pursuant to subsection 9709(d) of this title; or (F) a mental health patient representative. (2) The individual who explains the nature and effect of an advance directive to the principal under this subsection may be physically present in the same location as the principal at the time of the explanation or may deliver the explanation to the principal through a live, interactive, audio-video connection or by telephone. (f) A durable power of attorney for health care, terminal care document, or advance directive executed prior to the enactment of this chapter shall be a valid advance directive if the document complies with the statutory requirements in effect at the time the document was executed or with the provisions of this chapter. (g) A principal, a witness, or an individual who explains an advance directive under subsection (d) or (e) of this section may sign the advance directive or the explanation affirmation statement using a digital signature, provided that, for a remote witness, the conditions set forth in subdivision (b)(2) of this section shall be met.\", \"slug\": \"s10-vt-witness-limits\", \"source_url\": \"https://legislature.vermont.gov/statutes/section/18/231/09703\"}]", "source_urls": "https://legislature.vermont.gov/statutes/section/18/231/09703; https://www.healthvermont.gov/systems/advance-directives/create-register-and-make-changes-advance-directive; https://www.healthvermont.gov/systems/advance-directives/do-not-resuscitate-dnrclinician-orders-life-sustaining-treatment-colst", "state": "Vermont" }, { "advance": "Suggested statutory advance directive under section 54.1-2984", "advance_url": "https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/", "checked_on": "2026-10-22", "code": "VA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-va-advance\"], \"text\": \"Suggested statutory advance directive under section 54.1-2984\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/\"}, \"execution\": {\"facts\": [\"s10-va-execution\"], \"quote\": true, \"text\": \"A written advance directive shall be signed by the declarant in the presence of two subscribing witnesses and may (i) specify the health care the declarant does or does not authorize; (ii) appoint an agent to make health care decisions for the declarant; and (iii) specify an anatomical gift, after the declarant's death, of all of the declarant's body or an organ, tissue or eye donation pursuant to Article 2 (§ 32.1-291.1 et seq.) of Chapter 8 of Title 32.1.\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2983/\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/\"}, \"polst\": {\"facts\": [\"s10-va-dnr\"], \"text\": \"Durable Do Not Resuscitate Program\", \"url\": \"https://www.vdh.virginia.gov/emergency-medical-services/trauma-critical-care/durable-do-not-resuscitate-program/\"}}, \"facts\": [\"s10-va-advance\", \"s10-va-dnr\", \"s10-va-execution\"], \"id\": \"va\", \"notes\": [], \"office_url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/\", \"state\": \"Virginia\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "A written advance directive shall be signed by the declarant in the presence of two subscribing witnesses and may (i) specify the health care the declarant does or does not authorize; (ii) appoint an agent to make health care decisions for the declarant; and (iii) specify an anatomical gift, after the declarant's death, of all of the declarant's body or an organ, tissue or eye donation pursuant to Article 2 (§ 32.1-291.1 et seq.) of Chapter 8 of Title 32.1.", "execution_url": "https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2983/", "fact_slugs": "s10-va-advance; s10-va-dnr; s10-va-execution", "financial": "Not published", "financial_url": "https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/", "next_check_on": "2027-01-22", "office_url": "https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/", "polst": "Durable Do Not Resuscitate Program", "polst_url": "https://www.vdh.virginia.gov/emergency-medical-services/trauma-critical-care/durable-do-not-resuscitate-program/", "publishers": "Virginia Department of Health; Virginia General Assembly", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Virginia General Assembly\", \"quote\": \"An advance directive executed pursuant to this article may, but need not, be in the following form:\", \"slug\": \"s10-va-advance\", \"source_url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Virginia Department of Health\", \"quote\": \"Durable Do Not Resuscitate Program\", \"slug\": \"s10-va-dnr\", \"source_url\": \"https://www.vdh.virginia.gov/emergency-medical-services/trauma-critical-care/durable-do-not-resuscitate-program/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Virginia General Assembly\", \"quote\": \"A written advance directive shall be signed by the declarant in the presence of two subscribing witnesses and may (i) specify the health care the declarant does or does not authorize; (ii) appoint an agent to make health care decisions for the declarant; and (iii) specify an anatomical gift, after the declarant's death, of all of the declarant's body or an organ, tissue or eye donation pursuant to Article 2 (§ 32.1-291.1 et seq.) of Chapter 8 of Title 32.1.\", \"slug\": \"s10-va-execution\", \"source_url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2983/\"}]", "source_urls": "https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2983/; https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2984/; https://www.vdh.virginia.gov/emergency-medical-services/trauma-critical-care/durable-do-not-resuscitate-program/", "state": "Virginia" }, { "advance": "Statutory health care directive under RCW 70.122.030", "advance_url": "https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030", "checked_on": "2026-10-22", "code": "WA", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-wa-advance\"], \"text\": \"Statutory health care directive under RCW 70.122.030\", \"url\": \"https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030\"}, \"execution\": {\"facts\": [\"s10-wa-execution\"], \"quote\": true, \"text\": \"The directive shall be signed by the declarer and acknowledged before a notary public or other individual authorized by law to take acknowledgments or signed by the declarer in the presence of two witnesses not related to the declarer by blood or marriage and who would not be entitled to any portion of the estate of the declarer upon declarer's decease under any will of the declarer or codicil thereto then existing or, at the time of the directive, by operation of law then existing. In addition, a witness to a directive shall not be the attending physician, an employee of the attending physician or a health facility in which the declarer is a patient, or any person who has a claim against any portion of the estate of the declarer upon declarer's decease at the time of the execution of the directive.\", \"url\": \"https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030\"}, \"financial\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030\"}, \"polst\": {\"facts\": [\"s10-wa-polst\"], \"text\": \"Portable Orders for Life Sustaining Treatment\", \"url\": \"https://doh.wa.gov/public-health-provider-resources/emergency-medical-services-ems-and-trauma-care-system/portable-orders-life-sustaining-treatment-polst\"}}, \"facts\": [\"s10-wa-advance\", \"s10-wa-execution\", \"s10-wa-polst\"], \"id\": \"wa\", \"notes\": [], \"office_url\": \"https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030\", \"state\": \"Washington\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "The directive shall be signed by the declarer and acknowledged before a notary public or other individual authorized by law to take acknowledgments or signed by the declarer in the presence of two witnesses not related to the declarer by blood or marriage and who would not be entitled to any portion of the estate of the declarer upon declarer's decease under any will of the declarer or codicil thereto then existing or, at the time of the directive, by operation of law then existing. In addition, a witness to a directive shall not be the attending physician, an employee of the attending physician or a health facility in which the declarer is a patient, or any person who has a claim against any portion of the estate of the declarer upon declarer's decease at the time of the execution of the directive.", "execution_url": "https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030", "fact_slugs": "s10-wa-advance; s10-wa-execution; s10-wa-polst", "financial": "Not published", "financial_url": "https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030", "next_check_on": "2027-01-22", "office_url": "https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030", "polst": "Portable Orders for Life Sustaining Treatment", "polst_url": "https://doh.wa.gov/public-health-provider-resources/emergency-medical-services-ems-and-trauma-care-system/portable-orders-life-sustaining-treatment-polst", "publishers": "Washington State Department of Health; Washington State Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Washington State Legislature\", \"quote\": \"The directive may be in the following form and may include a notarial certificate for an acknowledgment in an individual capacity in short form as permitted by state law, but in addition may include other specific directions:\", \"slug\": \"s10-wa-advance\", \"source_url\": \"https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Washington State Legislature\", \"quote\": \"The directive shall be signed by the declarer and acknowledged before a notary public or other individual authorized by law to take acknowledgments or signed by the declarer in the presence of two witnesses not related to the declarer by blood or marriage and who would not be entitled to any portion of the estate of the declarer upon declarer's decease under any will of the declarer or codicil thereto then existing or, at the time of the directive, by operation of law then existing. In addition, a witness to a directive shall not be the attending physician, an employee of the attending physician or a health facility in which the declarer is a patient, or any person who has a claim against any portion of the estate of the declarer upon declarer's decease at the time of the execution of the directive.\", \"slug\": \"s10-wa-execution\", \"source_url\": \"https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Washington State Department of Health\", \"quote\": \"Portable Orders for Life Sustaining Treatment (POLST)\", \"slug\": \"s10-wa-polst\", \"source_url\": \"https://doh.wa.gov/public-health-provider-resources/emergency-medical-services-ems-and-trauma-care-system/portable-orders-life-sustaining-treatment-polst\"}]", "source_urls": "https://apps.leg.wa.gov/rcw/default.aspx?cite=70.122.030; https://doh.wa.gov/public-health-provider-resources/emergency-medical-services-ems-and-trauma-care-system/portable-orders-life-sustaining-treatment-polst", "state": "Washington" }, { "advance": "Optional statutory living will and medical power of attorney forms", "advance_url": "https://code.wvlegislature.gov/16-30-4/", "checked_on": "2026-10-22", "code": "WV", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-wv-advance\"], \"text\": \"Optional statutory living will and medical power of attorney forms\", \"url\": \"https://code.wvlegislature.gov/16-30-4/\"}, \"execution\": {\"facts\": [\"s10-wv-execution\"], \"quote\": true, \"text\": \"A living will, medical power of attorney, or combined medical power of attorney and living will made pursuant to this article shall be: (1) In writing; (2) executed by the principal or by another person in the principal’s presence at the principal’s express direction if the principal is physically unable to do so; (3) dated; (4) signed in the presence of two or more witnesses eat least 18 years of age; and (5) signed and attested by such witnesses whose signatures and attestations shall be acknowledged before a notary public.\", \"url\": \"https://code.wvlegislature.gov/16-30-4/\"}, \"financial\": {\"facts\": [\"s10-wv-financial\"], \"text\": \"Statutory form power of attorney under section 39B-3-101\", \"url\": \"https://code.wvlegislature.gov/39B-3-101/\"}, \"polst\": {\"facts\": [\"s10-wv-post\"], \"text\": \"Portable Orders for Scope of Treatment\", \"url\": \"https://code.wvlegislature.gov/email/16-30/\"}}, \"facts\": [\"s10-wv-advance\", \"s10-wv-execution\", \"s10-wv-financial\", \"s10-wv-post\", \"s10-wv-witness-limits\"], \"id\": \"wv\", \"notes\": [{\"facts\": [\"s10-wv-witness-limits\"], \"text\": \"The law excludes specified relatives, estate interests, the attending physician and named health care representatives as witnesses. A beneficiary-knowledge exception appears in the full section.\"}], \"office_url\": \"https://code.wvlegislature.gov/16-30-4/\", \"state\": \"West Virginia\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. The law excludes specified relatives, estate interests, the attending physician and named health care representatives as witnesses. A beneficiary-knowledge exception appears in the full section.", "execution": "A living will, medical power of attorney, or combined medical power of attorney and living will made pursuant to this article shall be: (1) In writing; (2) executed by the principal or by another person in the principal’s presence at the principal’s express direction if the principal is physically unable to do so; (3) dated; (4) signed in the presence of two or more witnesses eat least 18 years of age; and (5) signed and attested by such witnesses whose signatures and attestations shall be acknowledged before a notary public.", "execution_url": "https://code.wvlegislature.gov/16-30-4/", "fact_slugs": "s10-wv-advance; s10-wv-execution; s10-wv-financial; s10-wv-post; s10-wv-witness-limits", "financial": "Statutory form power of attorney under section 39B-3-101", "financial_url": "https://code.wvlegislature.gov/39B-3-101/", "next_check_on": "2027-01-22", "office_url": "https://code.wvlegislature.gov/16-30-4/", "polst": "Portable Orders for Scope of Treatment", "polst_url": "https://code.wvlegislature.gov/email/16-30/", "publishers": "West Virginia Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"West Virginia Legislature\", \"quote\": \"The living will may, but need not, be in the following form and may include other specific directions not inconsistent with other provisions of this article. Should any of the other specific directions be held to be invalid, the invalidity may not affect other directions of the living will which can be given effect without the invalid direction and to this end the directions in the living will are severable.\", \"slug\": \"s10-wv-advance\", \"source_url\": \"https://code.wvlegislature.gov/16-30-4/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"West Virginia Legislature\", \"quote\": \"A living will, medical power of attorney, or combined medical power of attorney and living will made pursuant to this article shall be: (1) In writing; (2) executed by the principal or by another person in the principal’s presence at the principal’s express direction if the principal is physically unable to do so; (3) dated; (4) signed in the presence of two or more witnesses eat least 18 years of age; and (5) signed and attested by such witnesses whose signatures and attestations shall be acknowledged before a notary public.\", \"slug\": \"s10-wv-execution\", \"source_url\": \"https://code.wvlegislature.gov/16-30-4/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"West Virginia Legislature\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by this act.\", \"slug\": \"s10-wv-financial\", \"source_url\": \"https://code.wvlegislature.gov/39B-3-101/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"West Virginia Legislature\", \"quote\": \"“Portable orders for scope of treatment (POST) form” means a standardized form containing orders by a qualified physician, an advanced practice registered nurse, or a physician assistant that details a person’s life-sustaining wishes as provided by §16-30-25 of this code.\", \"slug\": \"s10-wv-post\", \"source_url\": \"https://code.wvlegislature.gov/email/16-30/\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"West Virginia Legislature\", \"quote\": \"In addition, a witness may not be: (1) The person who signed the living will, medical power of attorney, or combined medical power of attorney and living will on behalf of and at the direction of the principal; (2) Related to the principal by blood or marriage; (3) Entitled to any portion of the estate of the principal under any will of the principal or codicil thereto: Provided, That the validity of the living will, medical power of attorney, or combined medical power of attorney and living will may not be affected when a witness at the time of witnessing the living will, medical power of attorney, or combined medical power of attorney and living will was unaware of being a named beneficiary of the principal’s will; (4) Directly financially responsible for the principal’s medical care; (5) The attending physician; or (6) The principal’s medical power of attorney representative or successor medical power of attorney representative.\", \"slug\": \"s10-wv-witness-limits\", \"source_url\": \"https://code.wvlegislature.gov/16-30-4/\"}]", "source_urls": "https://code.wvlegislature.gov/16-30-4/; https://code.wvlegislature.gov/39B-3-101/; https://code.wvlegislature.gov/email/16-30/", "state": "West Virginia" }, { "advance": "Power of Attorney for Health Care", "advance_url": "https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf", "checked_on": "2026-10-22", "code": "WI", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [\"s10-wi-advance\"], \"text\": \"Power of Attorney for Health Care\", \"url\": \"https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf\"}, \"execution\": {\"facts\": [\"s10-wi-execution\"], \"quote\": true, \"text\": \"Two witnesses are required. Witnesses must be at least 18 years of age, not related to you by blood, marriage, domestic partnership, or adoption, and not directly financially responsible for your health care. A witness cannot be a health care provider who is serving you at the time the document is signed or an employee of the health care provider unless the employee is a chaplain or social worker. A witness cannot be an employee of an inpatient health care facility in which you are a patient, unless the employee is a chaplain or social worker. A witness cannot be your health care agent nor have a claim on any portion of your estate.\", \"url\": \"https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf\"}, \"financial\": {\"facts\": [\"s10-wi-financial\"], \"text\": \"Wisconsin statutory power of attorney for finances and property\", \"url\": \"https://www.dhs.wisconsin.gov/forms/advdirectives/f00036.pdf\"}, \"polst\": {\"facts\": [\"s10-wi-dnr\"], \"text\": \"Emergency Care DNR order and DNR bracelet program\", \"url\": \"https://www.dhs.wisconsin.gov/ems/dnr.htm\"}}, \"facts\": [\"s10-wi-advance\", \"s10-wi-dnr\", \"s10-wi-execution\", \"s10-wi-financial\"], \"id\": \"wi\", \"notes\": [], \"office_url\": \"https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf\", \"state\": \"Wisconsin\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "Two witnesses are required. Witnesses must be at least 18 years of age, not related to you by blood, marriage, domestic partnership, or adoption, and not directly financially responsible for your health care. A witness cannot be a health care provider who is serving you at the time the document is signed or an employee of the health care provider unless the employee is a chaplain or social worker. A witness cannot be an employee of an inpatient health care facility in which you are a patient, unless the employee is a chaplain or social worker. A witness cannot be your health care agent nor have a claim on any portion of your estate.", "execution_url": "https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf", "fact_slugs": "s10-wi-advance; s10-wi-dnr; s10-wi-execution; s10-wi-financial", "financial": "Wisconsin statutory power of attorney for finances and property", "financial_url": "https://www.dhs.wisconsin.gov/forms/advdirectives/f00036.pdf", "next_check_on": "2027-01-22", "office_url": "https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf", "polst": "Emergency Care DNR order and DNR bracelet program", "polst_url": "https://www.dhs.wisconsin.gov/ems/dnr.htm", "publishers": "Wisconsin Department of Health Services", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Wisconsin Department of Health Services\", \"quote\": \"Enclosed is the Power of Attorney for Health Care form you requested.\", \"slug\": \"s10-wi-advance\", \"source_url\": \"https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Wisconsin Department of Health Services\", \"quote\": \"DNR orders only focus on CPR. The purpose of the DNR order is to make sure that your wishes are honored, no matter what facility you go to in an emergency.\", \"slug\": \"s10-wi-dnr\", \"source_url\": \"https://www.dhs.wisconsin.gov/ems/dnr.htm\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Wisconsin Department of Health Services\", \"quote\": \"Two witnesses are required. Witnesses must be at least 18 years of age, not related to you by blood, marriage, domestic partnership, or adoption, and not directly financially responsible for your health care. A witness cannot be a health care provider who is serving you at the time the document is signed or an employee of the health care provider unless the employee is a chaplain or social worker. A witness cannot be an employee of an inpatient health care facility in which you are a patient, unless the employee is a chaplain or social worker. A witness cannot be your health care agent nor have a claim on any portion of your estate.\", \"slug\": \"s10-wi-execution\", \"source_url\": \"https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Wisconsin Department of Health Services\", \"quote\": \"WISCONSIN STATUTORY POWER OF ATTORNEY FOR FINANCES AND PROPERTY\", \"slug\": \"s10-wi-financial\", \"source_url\": \"https://www.dhs.wisconsin.gov/forms/advdirectives/f00036.pdf\"}]", "source_urls": "https://www.dhs.wisconsin.gov/ems/dnr.htm; https://www.dhs.wisconsin.gov/forms/advdirectives/f00036.pdf; https://www.dhs.wisconsin.gov/forms/advdirectives/f00085.pdf", "state": "Wisconsin" }, { "advance": "Not published", "advance_url": "https://wyoleg.gov/statutes/compress/title35.pdf", "checked_on": "2026-10-22", "code": "WY", "complete_row_json": "{\"cells\": {\"advance\": {\"facts\": [], \"text\": \"Not published\", \"url\": \"https://wyoleg.gov/statutes/compress/title35.pdf\"}, \"execution\": {\"facts\": [\"s10-wy-execution\"], \"quote\": true, \"text\": \"The durable power of attorney must be acknowledged before a notarial officer or must be signed by at least two (2) witnesses, each of whom witnessed either the signing of the instrument by the principal or the principal's acknowledgement of the signature or of the instrument, each witness making the following declaration in substance: I declare under penalty of perjury under the laws of Wyoming that the person who signed or acknowledged this document is known to me to be the principal, and the principal signed or acknowledged this document in my presence. (c) None of the following shall be used as a witness for a power of attorney for health care: (i) A treating health care provider or employee of the provider; (ii) The attorney-in-fact nominated in the writing; (iii) The operator of a community care facility or employee of the operator or facility; (iv) The operator of a residential care facility or employee of the operator or facility.\", \"url\": \"https://wyoleg.gov/statutes/compress/title35.pdf\"}, \"financial\": {\"facts\": [\"s10-wy-financial\"], \"text\": \"Statutory form power of attorney under section 3-9-301\", \"url\": \"https://wyoleg.gov/statutes/compress/title03.pdf\"}, \"polst\": {\"facts\": [\"s10-wy-polst\"], \"text\": \"WyoPOLST portable medical orders\", \"url\": \"https://health.wyo.gov/aging/communityliving/polst/\"}}, \"facts\": [\"s10-wy-execution\", \"s10-wy-financial\", \"s10-wy-polst\"], \"id\": \"wy\", \"notes\": [], \"office_url\": \"https://wyoleg.gov/statutes/compress/title35.pdf\", \"state\": \"Wyoming\"}", "conditions": "Excerpt only. Read the full source for witness qualifications, exceptions and signing instructions. This column concerns the health care document, not the financial power of attorney. Not published means we did not verify that field in the cited state sources. It does not establish that a form or program is unavailable. ", "execution": "The durable power of attorney must be acknowledged before a notarial officer or must be signed by at least two (2) witnesses, each of whom witnessed either the signing of the instrument by the principal or the principal's acknowledgement of the signature or of the instrument, each witness making the following declaration in substance: I declare under penalty of perjury under the laws of Wyoming that the person who signed or acknowledged this document is known to me to be the principal, and the principal signed or acknowledged this document in my presence. (c) None of the following shall be used as a witness for a power of attorney for health care: (i) A treating health care provider or employee of the provider; (ii) The attorney-in-fact nominated in the writing; (iii) The operator of a community care facility or employee of the operator or facility; (iv) The operator of a residential care facility or employee of the operator or facility.", "execution_url": "https://wyoleg.gov/statutes/compress/title35.pdf", "fact_slugs": "s10-wy-execution; s10-wy-financial; s10-wy-polst", "financial": "Statutory form power of attorney under section 3-9-301", "financial_url": "https://wyoleg.gov/statutes/compress/title03.pdf", "next_check_on": "2027-01-22", "office_url": "https://wyoleg.gov/statutes/compress/title35.pdf", "polst": "WyoPOLST portable medical orders", "polst_url": "https://health.wyo.gov/aging/communityliving/polst/", "publishers": "Wyoming Department of Health; Wyoming Legislature", "source_provenance_json": "[{\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Wyoming Legislature\", \"quote\": \"The durable power of attorney must be acknowledged before a notarial officer or must be signed by at least two (2) witnesses, each of whom witnessed either the signing of the instrument by the principal or the principal's acknowledgement of the signature or of the instrument, each witness making the following declaration in substance: I declare under penalty of perjury under the laws of Wyoming that the person who signed or acknowledged this document is known to me to be the principal, and the principal signed or acknowledged this document in my presence. (c) None of the following shall be used as a witness for a power of attorney for health care: (i) A treating health care provider or employee of the provider; (ii) The attorney-in-fact nominated in the writing; (iii) The operator of a community care facility or employee of the operator or facility; (iv) The operator of a residential care facility or employee of the operator or facility.\", \"slug\": \"s10-wy-execution\", \"source_url\": \"https://wyoleg.gov/statutes/compress/title35.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Wyoming Legislature\", \"quote\": \"A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by this act:\", \"slug\": \"s10-wy-financial\", \"source_url\": \"https://wyoleg.gov/statutes/compress/title03.pdf\"}, {\"checked_on\": \"2026-10-22\", \"next_check_on\": \"2027-01-22\", \"publisher\": \"Wyoming Department of Health\", \"quote\": \"The Portable Medical Orders (POLST) form gives seriously ill patients more control over their end-of-life care, including medical treatment such as a ventilator or feeding tube and cardiopulmonary resuscitation (CPR).\", \"slug\": \"s10-wy-polst\", \"source_url\": \"https://health.wyo.gov/aging/communityliving/polst/\"}]", "source_urls": "https://health.wyo.gov/aging/communityliving/polst/; https://wyoleg.gov/statutes/compress/title03.pdf; https://wyoleg.gov/statutes/compress/title35.pdf", "state": "Wyoming" } ], "updated": "2026-10-22" }